The National Institute for health and Care Excellence (Nice) announced last month (April 28) that people with high cholesterol who cannot take statins and whose high cholesterol is not well-controlled with ezetimibe alone are now eligible for treatment with bempedoic acid with ezetimibe on the NHS.

Bempedoic acid with ezetimibe is available in a fixed-dose combination, under the brand name Nustendi, or as a separate bempedoic acid tablet, Nilemdo. Both medicines are manufactured by Daiichi Sankyo.

Pharmacies can purchase Nilemdo and Nustendi from Alliance Healthcare, which has an exclusive distribution arrangement with Daiichi Sankyo for both products, a Daiichi spokesperson told C+D last week (May 12).

An Alliance Healthcare spokesperson confirmed that the wholesaler distributes both Nilemdo and Nustendi and said it has “good stock availability of both products”.

“We cannot comment on any specifics of the contract we have with Daiichi Sankyo, or with any other client,” they added.

Updated Nice guidance

People with high cholesterol are usually prescribed statins for lowering low-density lipoprotein cholesterol (LDL-C) levels. When their cholesterol levels are not lowered enough by statins only, they may take ezetimibe and either alirocumab or evolocumab, Nice said.

The Nice guidance published last month approves the administration of bempedoic acid with ezetimibe “for people who are unable to use statins and whose high cholesterol is not well-controlled with ezetimibe alone”.

Meindert Boysen, deputy chief executive and director of the Centre for Health Technology Evaluation at Nice, said that while “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,” he added.

Nice added: “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.”