NHS prescriptions surge to 1 billion in a single year

An incredible milestone has been reached, with a record 1 billion NHS prescriptions dispensed within a single year for the first time ever in England, according to new statistics compiled by the Health and Social Care Information Centre (HSCIC).

The figure was met during 2012 across England and represents a 62% surge from the previous decade, when 383.5 million items were dispensed. The billion prescriptions dispensed is the equivalent of 2.7 million items each a day, or over 1,900 a minute.

Other figures in a report released by the HSCIC show that on average the NHS dispensed 18.7 items per person in 2012, whilst in 2002 it was just 12.4 per person. Moreover, the net cost per item has dropped from £11.10 in 2002 to £8.50 in 2012.

It is believed that an increasingly large and aging population are behind the increase in prescriptions as well as more patents beginning to expire and inexpensive generic alternatives becoming available.
For example, the net cost of the cholesterol-boosting medication atorvastatin (marketed as Lipitor by U.S. Pharmaceutical giant Pfizer) dramatically dropped during 2011 and 2012 from £310.9 million to £166.6 million.

Since then, Pfizer have also lost the UK patent for Viagra, meaning certain other pharmaceutical companies are able to produce an erectile dysfunction medication that contains Viagra’s active ingredient sildenafil citrate, at a significantly lower cost to the patient. Sildenafil Teva and Sildenafil Actavis are two such examples to emerge since the UK Viagra patent ended on June 21.

In what could be a testament to Britain’s burgeoning obesity crisis, for the sixth consecutive year diabetes prescriptions were the biggest cost by treatment area, costing £768 million in 2012 – representing a 2.2% (£16 million) increase from 2011.

Since 1996 the number of people diagnosed with diabetes in the UK has risen from 1.4 million to 2.9 million, of which an estimated 90% are believed to have type 2, which can be caused by either being overweight or obese. Health experts predict that by 2025 5 million people in the UK will have diabetes.

Commenting on the prescription increase, HSCIC chairman Kingsley Manning said: “For the first time, one billion prescription medicines have been dispensed to our communities in just one year. This figure reflects a continuing upward trend in prescription numbers, which is in contrast to a recent fall in total net cost. Total costs have fallen for the second year running and are now at 2009 levels. Our report shows that, while people on average now receive more prescription items, the cost of these per head has dropped in the last two years.”

However, the figures also demonstrate a ‘notable’ rise in the number of antibiotics prescribed – which is causing huge concern. The Government’s chief medical officer has previously spoken of fear that the body’s increasing resistance to antibiotics is one of the biggest threats to modern health.

Professor Dame Sally Davies said many drugs are unnecessarily dished out for mild infections or illnesses and this helping to create a resistance to them, warning that even routine operations such as hip replacements could become fatal if we lose the ability to fight off infection.

Work-related stress could be dangerous for our cholesterol

If you are sitting down to read this whilst in a job you hate – now may be the time to reach for that stress ball.

According to Spanish researchers, stress at the workplace cam change the way our body processes fat, increase ‘bad’ LDL cholesterol levels, which then raises the risk of cardiovascular problems such as heart attack or stroke.  This disorder that causes the levels of fats and lipoproteins in the blood to be altered is known as ‘dyslipidemia’.

Published in the Scandinavian Journal of Public Health, the study was conducted by researchers from Ibermutuamur – a mutual insurance company specialising in work-related accidents and occupational illnesses – working with experts from the Virgen de la Victoria Hospital at Malaga and the Santiago de Compostela University.

There has long been an established connection between stressful jobs and an increased risk of coronary disease. Reasons for this are believed to be that stress makes us more likely to eat more unhealthy foods, smoke and drink alcohol.

In addition, data emanating from previous studies have suggested that stress could have an impact of levels of lipids in the blood by hindering the body’s metabolism. Unfortunately these studies included a relatively low sample size and sometimes demonstrated mixed results.

A strength of the study conducted in Spain is the fact it comprised of over 90,000 people. Ibermutuamur have annual medical check-ups and an incredible 430,000 people were assessed between 2005 and 2007 alone. Of these, a study questionnaire was distributed to over 100,000 randomly selected individuals and 91,593 responded. Participants were asked: “During the last year, have you frequently felt that you cannot cope with your usual job?” Those who replied ‘yes’ were deemed to have stress at work.

There were also 11 questions regarding any possible anxiety and depression symptoms, for example: “Have you felt keyed up, on edge?” and “Have you had difficulty relaxing?”

However, and somewhat strangely, diet was not taken into account in the questionnaire. Having a diet high in saturated fat can affect cholesterol levels. Some of the foods particularly bad in this aspect include: hard cheese, cream, lard, butter, cakes, biscuits, and sausages. It may well be that stress at the workplace leads people to opting for foods which are poor nutritionally and it is their diet responsible for an increase in bad cholesterol, and not the stress itself.

Nonetheless, the results from the study are intriguing and perhaps should encourage employers to try and minimise stress for their employees and create a positive work environment. In addition, Medical Specialists Pharmacy urge all readers to take a look at our article published last year for National Cholesterol Week in which we offered many tips to improve heart health and avoid high cholesterol.

Carlos Catalina, clinical psychologist and an expert in work-related stress at Ibermutuamur, said in a statement: “The workers who stated that they had experienced difficulties in dealing with their job during the previous 12 months – 8.7 percent – had a higher risk of suffering from dyslipidemia – a lipoproteins’ metabolic disorder that can manifest itself in an increase in total cholesterol, low-density lipoproteins, the ‘bad,’ cholesterol and triglyceride levels, in addition to a drop in high-density lipoproteins, the ‘good’ cholesterol. One of the mechanisms that could explain the relationship between stress and cardiovascular risk could be the changes in our lipid profile, which means higher rates of atheromatous plaque accumulation of the arteries.”

If you want to improve your cholesterol levels, Medical Specialists Pharmacy can help. ‘Crestor’ (Rosuvastatin) and ‘Lipitor’ (Atorvastatin) are prescription-only treatments that belong to a group of cholesterol-lowering medicines called statins. Along with a healthy low-fat diet, they lower ‘bad’ cholesterol (LDL-C), increase ‘good’ cholesterol (HDL-C), as well as slowing the progression of atherosclerosis in adults with high cholesterol. We are pleased to inform our patients that we also offer legal generic Atorvastatin, with prices from as little as just £11.25 per pack.

Chemical contained red meat may cause heart damage

A study carried out by researchers from Cleveland Clinic in Ohio, US, has found that the chemical L-carnitine can increase the risk of suffering from heart problems. Saturated fat and the manufacturing process involved with how meat is preserved are widely believed to be related to heart problems, but many health experts think there is more to it. 

Lead researcher of the new study, Dr Stanley Hazen, commented: “The cholesterol and saturated fat content of lean red meat is not that high, there’s something else contributing to increases in cardiovascular risk.”

L-carnitine is a nutrient which is contained in red meat, dairy products and some dietary supplements.  The study, published in the journal Nature Medicine, showed that the carnitine contained red meat was broken down by naturally occurring bacteria in the gut. 

However, this later resulted in higher levels of cholesterol and an increased risk of heart disease as the resulting broken down product - trimethylamine-N-oxide (TMAO), is known to speed up the build-up of plaque in arteries and cause them to harden (atherosclerosis) – a main cause of heart disease.

Part of the researchers’ investigations was conducted in humans, whilst other testing was carried out with mice. Studies involving animals can be sometimes difficult to interpret, and some degree of caution should be shown when generalising the findings to humans.

For the study, 77 healthy volunteers were administered a supplement of L-carnitine. Of this total, 26 were classified as vegans or vegetarians. Some of the meat-eaters in the group were told to eat an eight-ounce sirloin steak - this works out at around 180mg of L-carnitine.

Researchers then gave antibiotics to the participants for a one week period. These prevented bacteria in their gut from converting L-carnitine into TMAO. After this, the 77 people again were given L-carnitine. Tests were conducted on blood and urine at the beginning of the study and up to three weeks following L-carnitine being given. Some of the people also had their faeces analysed.

In addition, L-carnitine levels were checked in the blood of 2,595 other people, all of whom had attended a heart check-up. The researchers thought this would be an effective measure of assessing a potential link with L-carnitine levels and known cardiovascular disease, or risk of a cardiovascular event (i.e. a heart attack or stroke).

Finally, plaque levels were studied in the arteries of mice and this was done by comparing mice fed normally against a group of mice fed L-carnitine, for a 10 week period. Some of these mice were given antibiotics beforehand. 

The main findings were:

. Meat-eaters produced more TMAO compared to vegans or vegetarians following L-carnitine ingestion.

. A ‘significant’ link was found between L-carnitine concentrations and risk of cardiovascular event in those having heart check-ups. However this was only for those with a high TMAO concentration. Researchers state they believe this shows that TMAO, rather than L-carnitine, is the main factor of this link.

. A study of the faeces showed L-carnitine affected how much TMAO was in the blood.

. Mice given L-carnitine, were at a double risk of developing a plaque build-up in their arterial walls, - but only when they had their normal gut bacteria. When the animals were given antibiotics to clear the gut, L-carnitine did not cause the same arterial wall build-up.

Dr Hazen says that TMAO can be underestimated, and said: “It may be a waste product but it is significantly influencing cholesterol metabolism and the net effect leads to an accumulation of cholesterol. The findings support the idea that less red meat is better. I used to have red meat five days out of seven, now I have cut it way back to less than once every two weeks or so.”

A vegetarian diet can boost blood pressure and cholesterol

A Cancer Research UK and the UK Medical Research Council-funded study featured in American Journal of Clinical Nutrition suggests that those who adhere to a vegetarian diet and ditch meat and fish will see major health benefits over their meat-eating peers.

The findings of what is the largest study of its kind, could persuade some people to give-up meat in favour of veg and comes ironically only weeks after the Tesco horse meat scandal where some of their own-branded beef burgers were found to contain as much as 29% horse meat.

Scientists at the University of Oxford analysed 44,561 people in England and Scotland, recruiting participants over the age of 20 during 1993 to 1997. They specifically wanted vegetarians and vegans in the study to look at associations between nutrition and general health in contrast to the general UK population.

All participants were required to fill out a food-frequency questionnaire that quizzed them on what food they ate over the previous year, in addition to asking them about exercise, smoking habits and alcohol consumption. The researchers classified people as either non-vegetarian if they said they had eaten any meat or fish, or as vegetarian if they reported eating no meat or fish. For study purposes, vegetarians and vegans were categorised together (about 15,100 in total).

Over the course of an average 11.6 years of follow-ups, there were 1,235 cases of ischaemic heart disease (IHD). From this number, 169 people in the study had died as a result of heart disease and there were 1,066 recorded hospital admissions.

After taking into account factors such as age, gender, physical activity, smoking, alcohol intake, education and social background, it was calculated that being a vegetarian can decrease the risk of death or hospital admission from heart disease by a staggering 32%. Amazingly, a reduced risk was evident in both continuous vegetarians and in those who had begun eating meat at the five year follow-up.

If that wasn’t enough of a persuader to ditch the meat, vegetarians were also found to have lower levels of ‘bad’ cholesterol in their blood and a lower systolic blood pressure reading. Moreover, they were typically more slender with a lower body mass index (BMI) than the meat eaters, and had a reduced risk of developing diabetes.

Dr Francesca Crowe, author of the study at the Cancer Epidemiology Unit at the University of Oxford, said: “Most of the difference in risk is probably caused by effects on cholesterol and blood pressure, and shows the important role of diet in the prevention of heart disease.”
Co-author Professor Tim Key, deputy director of the Cancer Epidemiology Unit at the University of Oxford, added: “The results clearly show the risk of heart disease in vegetarians is about a third lower than in non-vegetarians.”

Red meat – particularly processed meat – comprises of numerous ingredients that have been regular attributed to increased risk of chronic diseases including bowel cancer. Such ingredients include heme iron, saturated fat, sodium, nitrites and certain carcinogens that are formed during the cooking process. At least by hitting the daily recommended intake of five portions of fruit and veg means that people can benefit from their antioxidant properties that work at reducing cholesterol, control blood glucose levels and reduce the risk of many types of cancer.

Cardiovascular disease is responsible for the largest number of deaths in the developed world. According to World Health Organisation statistics, it claimed 17.3 million lives in 2008 worldwide, with 6.2 million of these from strokes. A famous figure who almost succumbed to heart disease was former U.S. President Bill Clinton, once notorious for his strong penchant for hamburgers; he was required to have a coronary bypass operation in 2004 and is now leads a much better lifestyle.

As highlighted earlier, high cholesterol is a primary contributor for heart disease. However, Medical Specialists Pharmacy provides online consultations for patients with high cholesterol and with our help you can reduce the risk of developing heart problems. For suitable patients our in-house doctors can prescribe statin medication (Lipitor and Crestor), and our in house pharmacists can dispense to patients within 24 hours. We also dispense statins for patients who can provide a private prescription, and in 2012 we introduced the legally available generic Atorvastatin at much lower prices for suitable patients.

Statins help to cut heart attack deaths by half

Firstly, Medical Specialists Pharmacy would like to wish everybody a slightly belated Merry Christmas and we hope everyone has had a fantastic few days with their family, friends and loved ones.

Secondly, we have already touched upon one group of people who may be vulnerable at Christmas time; asthmatics. However, those at risk of high cholesterol and heart problems need to be particularly cautious as well over the festive period.

Yesterday (Dec 26) is a day notorious for a high number of cardiac-related health problems such as heart attacks, heart failure and arrhythmias. A 2004 study conducted by researchers at the University of California, San Diego and Tufts University discovered that heart-related deaths go up by almost 5% during the Christmas holidays.

Some of the increased deaths can be attributed to a number of causes such as alcohol abuse as people already at risk of heart problems ignore the warnings and consume alcohol in excess, and some of the tragic fatalities are down to a build-up of Cholesterol – an important component of the blood stream that works at repairing body cells. However if excess cholesterol is not efficiently removed from the blood stream, it can pose a serious problem and cause deadly health issues such as stroke, heart attack and coronary heart disease.

As everybody is aware, stress levels for the majority of the UK and indeed around the world are at their peak over Christmas time as we frantically rush around for presents, planning time to see family and friends, and sorting last minute arrangements. Unfortunately stress and cholesterol are closely linked and when our stress levels increase, the production of two hormones – cortisol and adrenaline also increase.

Cortisol is known as the ‘stress hormone’ and it raises the sugars (glucose) in the bloodstream. Prolonged levels of cortisol have been shown to be connected to increased abdominal fat – linked to higher levels of ‘bad’ cholesterol (LDL) and lower levels of ‘good’ cholesterol (HDL), which can lead to all kinds of heart problems.

Cholesterol lowering medicines known as ‘Statins’ have been in the news throughout 2012 as health experts uncover more exciting findings about their capabilities. As stress and over indulgence of fatty foods increase our cholesterol over Christmas, it may come as good news to learn that British Heart Foundation statistics show that deaths from heart attacks have been cut by half, saving the lives of millions of people and this has been largely down to ‘wonder drug’ statins such as Crestor and Lipitor.

According to figures released by the British Heart Foundation, between the years 2002 and 2010 the death rate in men dropped from 78.7 deaths per 100,000 men to just 39.2 deaths per 100,000 men. Over the same 8 year block there was also a decrease in the death rate for females, 37.3 deaths per 100,000 women in 2002 fell to 17.7 deaths per 100,000 women in 2010.

The higher use of statin medication and blood thinning medication in conjunction with such lifestyle factors as fewer people now smoking have resulted in the decrease in heart attacks and other related problems. In addition, more advanced treatment than previous years means that those who do suffer from a heart attack, have a much better chance of surviving.

Professor Peter Weissburg, medical director of the foundation, said: “The last decade has seen excellent progress in heart attack prevention, treatment and care which has resulted in a dramatic reduction in the number of people dying from heart disease. Statins are an important part of that success story. They have undoubtedly changed the face of heart disease treatment for the better and there can be little doubt that there are thousands of people alive and well today because of statins. Whilst some people do experience irritating side effects, they are very rarely life threatening and the benefits far outweigh any risks. The progress we have witnessed over the last 10 years is something to celebrate but coronary heart disease is far from beaten and is still the single biggest killer in the UK. We must tackle the problem of inequalities which place an unfair burden of heart disease on our poorest communities. By dealing with the root causes of heart and circulatory disease – diet, smoking and lack of exercise – we should continue to see a decline in the numbers dying from a heart attack.”

Prescriptions for statins are now an incredible 15 times higher than 20 years ago, with estimates showing that approximately eight million people in the UK take statins every day. They work out to cost around just 40p per day and their benefits have led for calls for even more ‘healthy’ adults to be prescribed them too.

Thankfully, Medical Specialists Pharmacy provides private and confidential online consultations for statins, and for suitable patients our in-house doctors can prescribe statin medication such as Lipitor and Crestor, and our in-house pharmacists can dispense to patients within just 24 hours. We also dispense statins for patients who can provide a private prescription. If all that wasn’t enough, we also have the legally available generic Atorvastatin at much lower prices for suitable patients.

Daily ‘polypill’ could give 11 years of extra life to the over-50s

Experts behind a new four-in-one ‘polypill’ claim that the drug could potentially save the lives of 200,000 people every year. The tablet is said to contain three separate blood pressure lowering medications mixed together with a cholesterol-busting statin.

Statins are used in conjunction with a healthy diet and work by lowering ‘bad’ cholesterol (LDL) and triglycerides. Many studies conducted this year so far have proven their worth. There have been calls for even ‘healthy’ adults to be given them, as statins such as Crestor may massively benefit them in the future. Therefore, it is no surprise that more research has been carried out into their potential.
The new polypill could work-out at costing patients less than £1 per day and there have been claims it can give over 50s the blood pressure and cholesterol readings of somebody in their 20s. This could add on an extra 11 years of living to the average Brit.

Analysis of the potential new drug was conducted at Queen Mary, University of London. Researchers decided to use a statin with three already available blood pressure drugs. For the study, 84 people over the age of 50 years old were tested. Patients were assigned either the polypill or a dummy pill, once a day over a three month time period. Therapies were then switched after the three months and patients spent an additional three months taking the other pill.

After the six months it was noted that the polypill successfully lowered blood pressure by 12% and LDL cholesterol by 39%. The beneficial effects seen in the therapy has resulted in Dr David Wald, the cardiologist who led the research, calling for the drug to be made available over the counter and without the requirement of a prescription.

Dr Wald says, “The health implications of our results are large. If people took the polypill from age 50, an estimated 28% would benefit by avoiding or delaying a heart attack or stroke during their lifetime. On average, those who benefit would gain 11 years of life without a heart attack or stroke. When something like this is developed it should be made available as quickly as possible. How people pay for it is a judgment society needs to make.”

His comments for a quick release of the drug have come about after acknowledging it could yet be another 1 to 2 years before the medication has even been given an official approval by health regulators. If you are suffering from high cholesterol then it would be in your interest to act today and not wait the few years it could take for the polypill to possibly be approved.

In addition, others have warned for a degree of caution when considering how effective the polypill may be. The British Heart Foundation’s senior cardiac nurse, Natasha Stewart, commented, “Research into polypills is encouraging, but there are still many questions to answer before this ‘wonder drug’ is prescribed by doctors. This research only studied a very small number of people, so we’d need to see further large scale trials on a wider population to get more detailed results. However interesting this potential new pill is, medicines are not a substitute for living a healthy lifestyle. Staying active, eating healthily and not smoking are still vital ways to help keep your heart in good shape.”

In the UK the average cholesterol reading is 5.8mmol/l, which means that many people are not adhering to Natasha’s advice to stay in ‘good shape’. To put this into context, this is nearly double the average cholesterol reading of the East (e.g. China), and some Brits have much higher readings. This means a large percentage of the population are at risk of heart disease, strokes and narrowing of the arteries (atherosclerosis). One of the explanations for the average high reading shown for the UK could be down to the fact there are approximately 10 million adults who are smoking. Quitting smoking can have positive impacts to cholesterol levels and more health conditions such as asthma, etc., as we reported earlier this month.

When it comes to your health, the time to act is NOW. Do not wait one or two years for the next ‘miracle’ drug. Medical Specialists Pharmacy provides private and confidential online consultations, and for suitable patients our in-house doctors can prescribe statin medication (Lipitor and Crestor), and our in-house pharmacists can dispense to patients within just 24 hours. We also dispense statins for patients who can provide a private prescription, and have recently introduced the legally available generic Atorvastatin at much lower prices for suitable patients.

Dark chocolate is found to be beneficial for the heart

Certain health benefits from eating dark chocolate have been widely known for a long time. For instance, consuming dark chocolate on a regular basis has been shown in studies to reduce LDL cholesterol by as much as 10%. It also contains many antioxidants, which help to get rid of ‘free radicals’ from the body, which cause oxidative damage to cells. Free radicals are linked to the aging process and may be a cause of cancer. If you eat foods that are rich in antioxidants like dark chocolate, they can protect you from different types of cancer and slow the aging process. Dark chocolate also contains vitamins and minerals to support your health, such as potassium, iron and magnesium.

If all that wasn’t good news for chocolate lovers, researchers at Melbourne’s Monash University have uncovered even more positive news in relation to dark chocolate. They carried out a study involving 2,013 Australians and determined that if the subjects ate approximately 3.5 ounces of dark chocolate every day that contained at least a 70% cocoa content, this was a good way to assess potential benefits. The researchers adopted a mathematical model to estimate the long-term health benefits and the total cost of a daily intake of dark chocolate. All subjects in the study had no previous history of heart disease or diabetes and were not taking any medication to aid blood pressure.

Lead researcher from the study, Ella Zomer, and her team claim over a 10 year period that 70 fatal and 15 non-fatal cardiovascular related events could be prevented in some high-risk patients if they did not miss any daily portions. The mathematical model also concluded that this treatment could cost people just 42$ a year. Zomer commented on the study’s findings, “We’ve predicted significant health benefits of eating 100 grams of dark chocolate everyday over a 10 year period. That’s about the equivalent of one premium quality block containing a minimum 70% cocoa. Our findings indicate dark chocolate therapy could provide an alternative to or be used to complement drug therapeutics in people at high risk of cardiovascular disease. We’re not suggesting that the high-risk group use dark chocolate as their only preventative measure, but in combination with sensible choices, such as exercise.”

The authors in the study have stressed though that they have not assessed the possible effectiveness of dark chocolate consumption on cardiovascular events except for nonfatal stroke and nonfatal myocardial infarction, such as heart failure. In addition, although they acknowledged the benefits of dark chocolate on blood pressure and cholesterol, they commented that drug interventions are still a lot more effective.

Effective medications to help reduce cholesterol include Crestor (Rosuvastatin) and Lipitor (Atorvastatin). These are prescription only medicines that belong to a group of cholesterol-lowering medicines called statins. Along with diet, they lower ‘bad’ cholesterol (LDL-C), increase ‘good’ cholesterol (HDL-C), and also slow the progression of atherosclerosis in adults with high cholesterol, as part of a treatment plan to lower cholesterol to goal. Medical Specialists Pharmacy are now pleased to inform our patients that we also offer legal generic Atorvastatin, with prices from as little as just £11.25 per pack.