To:

Dear colleagues,

In the 2025/26 priorities and operational planning guidance we indicated that cardiovascular disease (CVD) prevention is a key priority and that we intend to continue to prioritise its prevention and proactive care as part of effective population health management through the GP contract. This includes greater focus on the prevention of cardiovascular events by supporting GPs to treat more people to target blood pressure and lipid levels.

Lipid management is a key intervention for reducing CVD risk, but it is important that it is delivered as part of a pathway of care in which high intensity statins are the first-line pharmacological intervention, in line with NHS model pathways and NICE guidance [NG238]: Cardiovascular disease: risk assessment and reduction, including lipid modification.

However, we recognise that many patients will need to receive additional or alternative lipid lowering therapies to optimise the management of their CVD risk. Clinicians therefore need access to a range of treatments to provide optimal care to their patients.

To ensure that a full range of lipid management treatments is available, we have renegotiated an agreement with Novartis for continued access to inclisiran, maintaining the same price for current and new NHS patients in England until December 2027. Arrangements are in place so that revisions to this agreement from January 2028 do not impact patients already on treatment. This builds on the previous agreement that went live when NICE published its Technology Appraisal for inclisiran (TA 733) in October 2021. Uptake of inclisiran among the potential eligible population of around 600,000 has been slower than expected and we continue to work to address this.

Aligned to the new contract we have agreed through DHSC with Community Pharmacy England that community pharmacies and general practices will purchase inclisiran at a nominal charge of £45 and be reimbursed at £60 (an increase from £50), with the differential given to offset incurred costs. This update is planned for inclusion in the Drug Tariff from 1 April 2025.

The main costs of purchasing for community pharmacies and general practices will continue to be met centrally (with full costs met centrally for secondary care). Recognising that, the costs of inclisiran are set nationally and no local negotiations are possible on these locally. We have also agreed that any products (that is, inclisiran) in Part VIIIC(ii) of the Drug Tariff will not be subject to discount deduction for general practice (note: discount not deducted already applies for community pharmacies).

We have also removed the requirement for prior approval for use of inclisiran in secondary care (for example, the requirement for a Blueteq form to be completed), so the arrangements now mirror those for primary care where no prior approval is needed. Inclisiran will continue to be reimbursed under the current cost and volume process. The NHS Standard Contract Schedule 6a Reporting Requirements for drugs will still apply. Full reimbursement will depend on the provision of accurate data submitted through existing systems, meaning complete and accurate information in the provider’s drugs patient-level contract monitoring data submission (DrPLCM).

All the above changes are captured in our updated inclisiran funding and supply document.

To aid local discussions, a short slide deck is attached, which summarises the evidence for lipid management in support of CVD prevention. This deck is also available on FutureNHS (sign-in required). This summarises the evidence for lipid management in support of CVD prevention.

Thank you for your ongoing efforts to improve CVD prevention.

Yours sincerely,

Classification: Official
Publication reference: PRN01800_i