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 Pharmacists, who advised the pharmaceutical industry about the POM to
P switch of statins in 2004, have revealed that the profession has been
slow to adopt the new business opportunity which the switch offered. Noel
Wicks, a member of the panel that advised simvastatin manufacturers Johnson&Johnson
MSD, said: “It was a giant opportunity missed as far as the profession
was concerned. It could have been a complete public health bonanza for
pharmacy but we just let it slip away.”
The apparent failure by community pharmacists to use Zocor Heart-Pro to
increase their health promotion role in the high street, was not entirely
unexpected. The timing of the switch from POM to P in the summer of 2004
came as pharmacists were distracted by the proposals from the government
for the new pharmacy contract and there was little time left to consider
another new initiative, said Mr Wicks. But, according to pharmacist John
Blenkinsopp, who also advised Johnson&Johnson, that was not the only
problem. He believes that mistakes were made in the way the drug was marketed
and that the advertising should have been directed at female consumers,
rather than men, because it is usually women who are responsible for buying
OTC medicines.
Dr Blenkinsopp, a research fellow at the department of medicines management
at Keele University, said: “The health promotion opportunity which
simvastatin presented was innovative at the time because it was a preventive
medicine in an area which had never been available OTC before. I think
it has been a small missed opportunity for pharmacists.”
When the then health secretary John Reid announced that the Government
was achieving a world-first by giving a statin OTC status in July 2004,
he said the decision created an opportunity for pharmacists to boost their
clinical role in the high street as well as helping to reduce the risk
of heart disease.
This month, the Government report “Shaping the Future”, a progress
report on the National Service Framework on Coronary Heart Disease claimed
the number of lives saved in England with prescribed statins had tripled
since 2000 from 2,900 to 9,700 in 2005. These figures, however, do not
include the impact of OTC statins on lives saved because the Department
of Health does not monitor the sale of OTC medicines. That role is taken
by drug manufacturers.
But the DoH did confirm that the decision to change the status of simvastatin
reflected government policy to increase patient choice and make more prescription-only
drugs available OTC on condition that they are safe. A spokeswoman said: “Simvastatin
expanded the potential market by making the drug available to people at
moderate risk of developing CHD.”
Despite the initial lack of enthusiasm shown by the profession to promote
simvastatin, it could all be about to change. According to Mr Wicks, medicines
use reviews introduced under the new community pharmacy contract will create
new health promotion and health screening opportunities. ”We will
be talking to patients about risk factors and will be screening them so
it is possible that we could suggest that OTC statin is something they
may wish to consider to reduce their risk of CHD. I think it may give us
the opportunity to identify those patients who may benefit from simvastatin,” he
explained.
McNeil Ltd, the business arm of Johnson&Johnson with responsibility
for providing OTC treatments, including simvastatin, said it had no influence
over the timing of the decision to switch the statin from prescription-only
to OTC because it was in the hands of the Medicines and Healthcare products
Regulatory Agency and the Committee on Safety of Medicines. Company marketing
manager Caroline O’Dwyer said: “Zocor Heart-Pro was at its
launch a truly novel switch for which there was no blueprint for success.
Our expectations have always been that it would take time to be accepted
by both pharmacy and consumers, and there is no doubt that the environment
today is different from where it was at launch [nearly] three years ago.”
The increased health promotion and screening roles of pharmacists created
by their new contract will bring new opportunities for pharmacists to promote
heart health with their customers. “There has never been a better
time for pharmacy to raise its potential in helping prevent heart attacks,” Ms
O’Dwyer added. “We are confident that Zocor Heart-Pro will
continue to establish itself within pharmacy.”
McNeil Ltd would not reveal sales figures for Zocor Heart-Pro but said
that they matched its “internal forecasts”.
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The
Pharmaceutical Journal