ChEMBL

I've just got to 48 years old (or thirty-eighteen, in my newly favoured numbering scheme) and am taking stock of my personal health and underlying disease risks (I've just spat into my 23andMe tube - and I've got a the offer of guided expert interpretation of the results - I'm really lucky to work at the EBI for this sort of stuff). I already take low-dose aspirin, for it's reported protective effects in DVT and for various cancers. My kids say that it's about 38 years too late to start worrying about my health. But I feel frail suddenly.

Statins are great drugs, they significantly reduce the risk of cardiovascular events (that's a bit of a euphemism, isn't it?), and also there is a lot of evidence emerging for statins being potentially protective in a whole bunch of other inflammatory and proliferative disorders. Google is you friend in finding these sort of reports, so I won't evidence them here.

Simvastatin, a drug with huge patient exposure and safety data is now available in the UK (and several other places) Over The Counter (OTC) in a low dose form (10 mg) - the risk reduction in major CV events is 10% after a years dosing, and a third over three years at this dose (see here for a simple Q&A document) - this is pretty profound in my view. In fact there are many people who believe that above a threshold age, that most people should take statins.

An issue though is cost, if there was greatly increased coverage of people receiving statins, then the cost to the NHS (and the burden on the taxpayer) would be huge (remember this is a UK view, your local situation may well be different). With a well tolerated and safer form of statins (i.e. low dose), and general encouragement of the health benefits, and with them being available OTC (where the customer pays directly for the drug with no State involvement), at a population level, the health benefits would be great, and the cost of the benefit would be borne by the patient. Great all round! Of course, people at significantly higher than background risk can still get a prescription, monitoring and support, a higher dose form for more aggressive reduction of cholesterol levels).

So as a reasonably informed consumer, I decided to add statins to my daily routine. So I visited two large local pharmacies, only to be told that they no longer stock the OTC form (but there were visible packs of POM statins in all the pharmacies I visited. After wasting some time, I asked why they didn't stock them and was told the supplier doesn't deliver them any more, for both pharmacy chains. I called the helpline of Boots Company plc - and spoke to a representative, and they could not find OTC statins on their product list - quite odd - so I then asked the question - do they have any stores that actually stocked 10 mg OTC simvastatin? They couldn't answer, but put me through to a pharmacist at a major local branch - they were helpful, but confirmed OTC Simvastatin was an order only item. Hardly the best way to get 1) major population scale CV health benefits and 2) a shift in cost from State to patient.

It made me think a little - why is the supply chain not supplying OTC statins; but obviously, looking at the shelves in the pharmacies, having no problem with getting Branded Statins out?

Anyway, I am determined to get my OTC statins at my cost, and I'll post how I get on!

jpo

PS I also went to the dentist today and got two big fillings, and all I can say to the scientists who discovered and developed lidocaine is - you are Gods! Seriously, it was the first time I've ever opted for pain relief during dentistry, and I cannot believe what a difference it made, or how stupid I have been in the past.