Template component | Item | NICE | Local modifications | Reason for modification |
---|---|---|---|---|
Drug treatment | Proportions receiving statins | 20% simvastatin, 40% atorvastatin, 40% rosuvastatin | 20% simvastatin, 72% atorvastatin, 8% rosuvastatin | Atorvastatin has lost exclusivity. Medicines management discourages prescribing of rosuvastatin |
Cost of statins | Simvastatin 80 mg £60.36 per annum | Simvastatin 80 mg £29.33 per annum | April 2013 drug tariff | |
Atorvastatin 40 mg or 80 mg £367.74 per annum | Atorvastatin £35.33 per annum (average of £25.16 for 40 mg and £45.49 for 80 mg) | April 2013 drug tariff | ||
Cascade testing | Average number of relatives identified | 4 first degree, 8 second degree, 12 third degree | 3 first degree, 6 second degree, 9 third degree | SHIP programme will not benefit from relative identification in rest of England |
DNA test to identify indivudal mutation | £400 | £250 | Cost of sequencing has fallen | |
DNA test for previously identified mutation | £50 | £70 | Local cost higher | |
Annual review meeting | Proportion followed up in general practice | 28% in year 1, 52% in year 2, 64% in year 3 | 80% 3 in specialist and dual models. 100% in GP-led model | No local research programme established so programme can start with most/all follow-up by GPs |
Specialist referrals | Proportion referred to FH specialist | 30% | 30% in specialist model, 20% in dual-and GP-led model | With exception of specialist model there is great emphasis on care in general practice |
Cost of referreal to FH specialist | £355.47 | £322.00 | Local tariff |
FH, Familial hypercholesterolaemia; GP, general practitioner; NICE, National Institute for Health and Care Excellence; SHIP, Southampton, Hampshire, Isle of Wight and Portsmouth.