Prescribing Advice for GPs

An NHS Prescribing Advisers' Blog

Low-cost statins and QOF

The British Journal of General Practice has published the results of a study that aimed to identify any correlation between proportional use of low-cost stains and achievement in the cholesterol indicators of the Quality and Outcome Framework (QOF).

Data were analysed from the 2006-07 financial year comparing proportional use of low-cost statins with QOF achievement in the coronary heart disease (CHD8) and stroke (STROKE8) indicators for cholesterol (less than 5mmol/L).

The National electronic Library for Medicines reports indicates that statin use ranged from 33.6% to 93.6% (median 72.0%) and QOF achievement ranged from 36.4% to 98.1% (median 82.7%) and 46.7% to 97.2% (median 75.7%) for CHD and stroke respectively.

The author concludes that increasing use of lower-cost statins was associated with poorer outcomes on the QOF measures used however there are some limitations in this study.

The cholesterol indicator in the diabetes domain (DM17) was not analysed in this study. It is also unclear if exception reporting was accounted for in this analysis. Additionally, this study does not review clinical outcomes and extrapolating this data to that end is inappropriate.

Action: The results of this study do not change current prescribing practice of using simvastatin 40mg first line where clinically appropriate. Clinicians may need to be aware of this study in order to reassure patients who raise concerns.

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