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Esperion Therapeutics' non-statin therapy "bempedoic acid" has shown modest results in reducing the risk of major cardiovascular events in statin-intolerant patients in the cholesterol lowering via bempedoic acid, an ACL-inhibiting regimen (CLEAR Outcomes) trial, revealed GlobalData, a leading data and analytics company. As a result, there is substantial room for improvement in this space as a potential approval is expected in Australia in near-term based on these results, said GlobalData. According to GlobalData's Pharmaceutical Intelligence Center, the total number of diagnosed prevalent cases of dyslipidemia in Australia is expected to increase at a compound annual growth rate of approximately 1.2% from 5.2 million in 2022 to 5.4 million in 2025. Neha Myneni, Pharma Analyst at GlobalData, comments: "Bempedoic acid joins several statin alternatives that have shown the potential to reduce cardiac illnesses. However, with not much significant improvement in the outcomes, there exists a clear room for improvement for non-statin therapies in this space." Bempedoic acid is the sixth class of cholesterol-lowering drugs (other than cholesteryl-ester transfer protein isoform (CETPi) inhibitors), that has demonstrated the potential to reduce heart attacks and strokes. Other class of therapies with similar potential currently marketed in Australia include statins, bile acid resins, niacin, ezetimibe, and proprotein convertase subtilisin/kexin type 9 (PCSK9) inhibitors (alirocumab, evolocumab, and inclisiran).

Cardiovascular disease is the number one cause of death and number one cause of hospitalization in developed countries. Statin drugs are a common drug of choice in the prevention (lower cholesterol) and treatment of heart disease. The research is quite compelling showing the benefits of statin therapy. However does everyone need a statin?

The National Institute for Health and Care Excellence (NICE) has recommended icosapent ethyl also called Vazkepa manufactured by Amarin for adults who have cardiovascular disease with controlled LDL-C levels taking a statin. It's final draft guidance is expected to be available on the July 20. Nearly half a million people are expected to benefit from the first licensed treatment shown to reduce the risk of heart attacks and strokes in people with controlled low-density lipoprotein cholesterol (LDL-C - sometimes called "bad" cholesterol) who are taking a statin and who have raised levels of triglycerides. NICE said: "Clinical trial evidence suggests that for people with raised triglycerides who have LDL-C levels controlled by statins, and who have cardiovascular disease, icosapent ethyl reduces their risk of cardiovascular events by over a quarter compared with placebo. Helen Knight, interim director of medicines evaluation at NICE, said: "Icosapent ethyl is the first licensed treatment of its kind for people who are at risk of heart attacks and strokes despite well controlled LDL cholesterol because they have raised blood fats. And although lifestyle changes, including diet and exercise, can help to reduce their risk, these may not work for everyone.

This is a very long newsletter. I will answer questions about oil versus water-soluble Vitamin D, depression, mental clarity, malignant melanoma, Crohn's disease, an imagist poet, multiple sclerosis, sun-exposure, high-intensity red light and collagen repair in the skin, non-alcoholic fatty liver disease, influenza, the 1918 influenza pandemic, statins, the new Food and Nutrition Board, thyroid disease, chronic fatigue syndrome, athletes, the upcoming 14th Vitamin D Workshop, prostate cancer, the wrong blood test, pregnancy, autism, Alzheimer's disease, soap and sebum, asthma, sleep, the co-factors vitamin D needs to work (all contained in spinach), and-my favorite-UVC light and Vitamin D

More than a third of pharmacists who participated in a survey said they have seen an increase in patients declining prescriptions due to the cost in the last 12 months. The survey was jointly conducted by the Pharmacists' Defence Association (PDA) and the Royal Pharmaceutical Society (RPS), extending their support for the Prescription Charges Coalition (PCC). Responding to the survey, 90 per cent of pharmacists admitted seeing cases where patients decline all the medicines on a prescription due to cost. Nearly all respondents said they have seen cases where patients declined some of their prescribed medicines and more than a quarter of them have experienced such situation often. They have warned of the impact of prescription charges as patients are denying vital medicines, including those for blood pressure and mental health, inhalers, antibiotics, pain relief, and statins, which can have potential consequences for the individual's health.