An innovative new treatment for people at risk of cardiovascular disease will be made available to patients more quickly, thanks to a agreement between NHS England and NHS Improvement, the AHSN Network and the pharmaceutical company, Novartis.

Approved by NICE – inclisiran is the first of a new type of cholesterol-lowering treatment which uses RNA interference (RNAi) to boost the liver’s ability to remove harmful cholesterol from the blood. It can be given to people with high cholesterol who have already had a previous cardiovascular event to reduce the chances of them having another. It can be used on its own or alongside other cholesterol lowering drugs.

This collaboration will increase the treatment options available to this patient cohort and is an example of a new method of scaling an approved innovation in a way that accelerates patient access.

The AHSN Network, comprising the 15 Academic Health Science Networks (AHSNs) across England, will work with local Integrated Care Systems (ICSs) and Primary Care Networks (PCN) to enable patients to benefit rapidly from novel treatments, such as this.

Roll-out of the new drug, which can be given to patients in primary care as a twice-yearly injection, will become part of the on-going three-year AHSN Network’s lipids management and familial hypercholesterolemia (FH) national programme. The AHSN Network will support primary care teams with information, education and training to help them prescribe the most appropriate treatment for patients.

The 15 AHSNs, including Health Innovation Manchester, will work with clinical teams to identify and overcome any barriers and realise the benefits of this new therapy, prescribed alongside other medicines in the lipid management pathway, as quickly as possible. AHSN teams will support local organisations to develop care models and support awareness of the treatment and its benefit for patients within the lipids management pathway.

The AHSN programme complements a study currently underway in Greater Manchester and supported by Health Innovation Manchester, testing the implementation in primary care of inclisiran. The ground-breaking project, titled Study in Primary care evaluating Inclisiran delivery implementation + enhanced support (VICTORION-SPIRIT) is a collaboration between  Novartis, NHS England and Improvement, NorthWest EHealth, Health Innovation Manchester, and the National Institute for Health Research Applied Research Collaboration Greeter Manchester (NIHR ARC-GM).

Approximately 20 GP practices in Greater Manchester will participate in the implementation research study, recruiting 900 patients. The study will use research to identify the best ways to speed up adoption and spread across the NHS. It aims to support reducing the time it takes to bring new medicines into practice to benefit patients.

Professor Julia Newton, Medical Director at the AHSN for the North East and North Cumbria (AHSN NENC) and lead for the AHSN Network’s lipid management and FH programme, said: “This is a really exciting collaboration. We have been supporting clinical teams for the past year to identify those with high cholesterol and opportunities for better patient care. New treatments are becoming available that will allow clinicians and patients to choose the best treatment to manage cholesterol levels and this new collaboration allows us to go further quicker, to raise awareness of the risks of high cholesterol and how important it is to manage it effectively. It allows us to work with teams to bring these great new treatments, such as Inclisiran, to the patient more quickly.”

Historically, new innovative drugs that have been shown to be of benefit can take years to reach patients. There are many potential barriers to getting treatments into clinical practice at pace and scale, and this new collaboration between NHS England and NHS Improvement, the AHSN Network and Novartis will facilitate the exploration of these barriers and how to overcome them, with the aim of improving patient outcomes.

As the rollout of new treatments are not usually undertaken on a national scale, there is currently inequitable access across the country to novel treatments. This additional element of the lipids management and FH programme will help address inequalities by enabling all eligible patients to easily access the treatment via their GP practice.

Dr James Moore, GP at the Stoke Road Surgery, Cheltenham, said: “The availability of Inclisiran represents a significant and exciting milestone in managing those with established cardiovascular disease. As a GP, I care for patients in the community setting who have had heart attacks or strokes and who are therefore at higher risk of further cardiovascular events. This novel therapy can be introduced in primary care after standard treatment, to deliver a significant and sustained reduction in LDL (low-density lipoprotein) cholesterol, thereby addressing unmet needs in lipid management for this high-risk population.”

Cardiovascular disease is a significant challenge for the UK, as it is the cause of one death every three minutes and costs the UK economy £7.4 billion every year. People living in deprived areas of the UK are four times more likely to die from premature cardiovascular disease compared to less deprived areas.

Despite this, it is estimated that 3.5 million people are living with cardiovascular disease in the UK. High cholesterol is recognized as a significant risk factor for cardiovascular disease, with two out of three of those at risk being undertreated.

In October 2020, NHS England commissioned the AHSN Network to support the NHS to deliver an optimised cholesterol and lipid management pathway through a lipids optimisation and FH national programme. The ultimate aim of this three-year programme is to support the NHS Long Term Plan ambition of reducing cardiovascular deaths and disease.