Burnley surgeon calls for greater access to cholesterol-lowering NHS drug inclisiran
A retired Burnley vascular surgeon has spoken out about his battle to access a cholesterol-lowering drug which he believes could significantly reduce his risk of a major cardiovascular event.
Robert Hughes (81) previously worked as a vascular surgeon at Burnley General Hospital and says he now finds himself experiencing the issue “from both sides” after becoming a patient at high risk of cardiovascular complications.
He is calling for greater awareness of inclisiran, an injectable medicine administered every six months which can significantly reduce levels of low-density lipoprotein (LDL) cholesterol – often referred to as “bad” cholesterol.
Mr Hughes says he has been trying to access the treatment through his GP practice but has so far been unsuccessful.
He believes a number of patients across East Lancashire could potentially benefit from inclisiran but may not be aware that the treatment is available through the NHS.
“Therefore I know about this problem from both sides,” said Mr Hughes.
“It would probably make a dramatic difference to my life expectancy, but despite putting my local practice under intense and sometimes acrimonious pressure to prescribe it, I have failed.
“As far as I know there are a lot of people in East Lancashire who would benefit, but this argument over funding is preventing them getting it.”
Mr Hughes said his brother-in-law, who lives in Rochdale, had been encouraged by his GP to consider the treatment, while he had experienced a different situation locally.
However, NHS Lancashire and South Cumbria Integrated Care Board (ICB) said inclisiran is commissioned across Lancashire and South Cumbria, with patients assessed against the same national clinical criteria.
A spokesperson said: “Inclisiran is commissioned across Lancashire and South Cumbria, and patients should be assessed against the same national clinical criteria regardless of where they live within the ICB footprint.
“NHS systems may adopt different approaches to implementing cardiovascular prevention programmes. The pace of rollout can be influenced by local population health needs, investment decisions, workforce availability, provider readiness and the maturity of existing prevention programmes.
“Differences in implementation do not necessarily indicate differences in national policy or clinical guidance.”
According to the Lancashire and South Cumbria formulary, inclisiran can be considered for eligible patients with established cardiovascular disease where LDL cholesterol remains at 2.6 mmol/L or above, following appropriate lipid-lowering treatment.
National NHS guidance states that high-intensity statins are the first-line treatment for secondary prevention of cardiovascular disease, with additional treatments considered where cholesterol targets are not achieved or where other treatments are unsuitable.
NHS England also says inclisiran is funded centrally under current arrangements. GP practices and community pharmacies purchase it at a nominal charge of £45 per injection and are reimbursed £60, with the main cost of purchasing the medicine met centrally.
The ICB spokesperson added: “Inclisiran has a clearly defined place in care. Anyone who believes they may be suitable for Inclisiran should speak to their GP or specialist.
“They can make a shared decision together, based on clinical evidence and the patient's personal values and preferences to choose if this medical treatment and/or care plan is an appropriate treatment option.”
Mr Hughes believes the issue deserves greater public attention and says patients who could potentially benefit should be aware of the treatment and able to discuss it with their GP.