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Thousands with high cholesterol set to benefit from new treatment on the NHS

People with high cholesterol will soon have access to a new treatment option on the NHS, as a result of final National Institute for Health and Care Excellence (NICE) guidance published on 28 April 2021.

Around 70,000 adults in England with primary hypercholesterolaemia (heterozygous familial and non-familial) or mixed dyslipidaemia will now be eligible for treatment with bempedoic acid with ezetimibe, as an adjunct to diet, if statins are contraindicated or not tolerated, or ezetimibe alone does not control low-density lipoprotein cholesterol (LDL-C) well enough.

Current standard treatment for high cholesterol includes dietary changes and statins for lowering LDL-C levels. People may also be treated with ezetimibe and either alirocumab or evolocumab when their cholesterol levels are not lowered enough with the maximally tolerated dose of statins.

NICE's new recommendation is not intended to affect treatment with bempedoic acid with ezetimibe that was started in the NHS before this guidance was published. People having treatment outside this recommendation may continue without change to the funding arrangements in place for them before this guidance was published, until they and their NHS clinician consider it appropriate to stop.

Meindert Boysen, deputy chief executive and director of the Centre for Health Technology Evaluation at NICE, said: "High cholesterol, if left untreated, can lead to a range of serious health conditions. Although statins and other treatments are used successfully by a large portion of the population, some people may require other options to control their cholesterol."

"We are pleased to be able to recommend bempedoic acid with ezetimibe as a new treatment option for these individuals."

Bempedoic acid with ezetimibe are both taken once daily in tablet form. They can be used as separate tablets (Nilemdo by Daiichi Sankyo, plus ezetimibe) or in a fixed-dose combination (Nustendi by Daiichi Sankyo).

The full guidance can be accessed here.


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