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New Zealanders taking statin drugs to reduce their heart disease risks have far worse control of their cholesterol levels than Australians on the medicines, an audit has found.
Heart specialists are using the audit - commissioned by pharmaceutical company AstraZeneca - to press the Government to widen access to existing types of the cholesterol-lowering drugs and to pay for a new one made by Astra, rosuvastatin. It is the most potent statin available.
High cholesterol is a risk factor for cardiovascular disease, which includes heart disease and stroke. Cardiovascular disease is New Zealand's leading cause of death.
Astra says that of 6901 transtasman heart patients in the audit of statin users, 26 per cent of those in NZ achieved the NZ Heart Foundation's recommended total-cholesterol goal of 4 millimoles a litre of blood.
This contrasts with 51 per cent of Australians in the audit achieving the Australian Heart Foundation's target for LDL or "bad" cholesterol of 2 millimoles a litre.
Christchurch Hospital cardiologist Associate Professor John Elliott said the New Zealand figure was of great concern - "even more so when you consider that international [cholesterol] guidelines are lower still.
"We need an urgent change in the [Pharmac] special authority criteria that currently restrict access to existing therapies as well as better access to newer effective therapies."
Pharmac medical director Dr Peter Moodie had not seen the Astra-commissioned audit, but did have some questions. "You have to ask, was the sample adequate and correct; was the data correct; were the people taking the drug." If 74 per cent were above the cholesterol goal, that suggested they needed a dose adjustment.
He said about 250,000 New Zealanders used statins and the per-capita rate of use was the same on both sides of the Tasman. New Zealand's access to the drugs was more open than Australia's.
Pharmac's clinical advisory committee had rejected funding Astra's rosuvastatin in 2005, finding there was "no overwhelming clinical need at that time", Dr Moodie said.
"Potency only has importance for a small group of people who may not reach a target level and are at very high risk ... The vast majority of people do not need the most potent statin."
Pharmac already subsidised a higher-potency statin - although it is less potent than rosuvastatin - for patients who met certain criteria, he said.
Auckland City Hospital cardiologist Professor Harvey White said Pharmac's arguments were a "smokescreen".
"Of course potency is important and of course getting the level down is important. "We know that in Australia, higher doses of the drugs are used," Professor White said. "We know cardiac death rates have been falling faster in Australia than New Zealand."
National Party associate health spokeswoman Jackie Blue said Australians had wider access to more statins, including rosuvastatin.
