October 30th - Plant sterol-enriched spreads with cholesterol-lowering ability have the potential to reduce thousands of coronary events and save the NHS almost £90 million a year, according to a paper published today in the Journal of Medical Economics.

The paper entitled "Flora pro.activ: a clinical and financial impact analysis", uses published, peer-reviewed data to investigate the impact of a plant sterol spread on lipid profiles when used in combination with a healthy diet.

Authors concluded that plant sterol-enriched spreads, which can lower LDL cholesterol by 10-15% as part of a healthy diet 1,2,3, are highly cost-effective. They are easy to incorporate into the daily diet at no additional cost to the NHS and offer the potential to generate considerable future savings.

Co-author, Dr Jonathan Belsey commented:
"Our analysis shows that Flora pro.activ could help reduce the number of coronary events by a quarter of a million over a period of 5 years *. Based on the known costs and outcomes of myocardial infarctions, this means that NHS expenditure could drop by at least £86 million per year ".

These figures are based on usage in individuals without established coronary heart disease. However, the paper confirms that plant sterol-enriched spreads may also be used to good effect in patients with established coronary heart disease who have been prescribed statins.
Flora pro.activ works via a mechanism that is complimentary to that of statins. Studies have shown additional LDL cholesterol reductions of up to 15% in hypercholesterolaemic patients already treated with statins as well as those not currently receiving any drug therapy 4.

The cholesterol-lowering effect seen by a combination of both agents could mean that fewer patients would require high doses of statins. Furthermore, the authors concluded that more patients could be maintained on the minimum dose of statin by the concomitant use of Flora pro.activ. In a few cases of mild hypercholesterolaemia, drug therapy might be avoided altogether.

The cost savings within Primary Care could be considerable. Dr Rod Smith, president of the Association of Primary Care, commented:

"On average, a typical GP practice already spends £40,000 on lipid-lowering therapy each year. In order to reduce cholesterol to new target levels set out in the National Service Framework for CHD, this spend will need to be increased four or five-fold. Plant sterol-enriched margarines offer a genuine clinical gain at no additional cost to NHS prescribing budgets. This is good news for GPs."

The additional cost to patients using plant sterol-enriched spreads is modest - around £44 per year if a spread like Flora pro.activ (at £1.95 for a 250g tub) replaces a standard low fat spread.