NHS England Updates Guidance on Inclisiran for Lipid Management and CVD Prevention

Introduction

Inclisiran, a small interfering RNA (siRNA) therapy, is now a core option in lipid management pathways for individuals at high risk of cardiovascular events. NHS England’s updated guidance highlights continued access to inclisiran across primary and secondary care, aligning with national ambitions to prevent CVD and reduce health inequalities.

Access and Pricing Agreement

Under an agreement with Novartis, inclisiran will remain available at a cost-effective price for the NHS in England until the end of December 2027. This long-term arrangement ensures clinicians can continue to access inclisiran as part of a broad suite of lipid-lowering therapies, particularly for patients who are unable to reach lipid targets through statins or ezetimibe alone.

How the Virtual Hub Can Support

Our Virtual Hub team plays a key role in supporting lipid management and cardiovascular disease prevention across primary care. Through structured lipid reviews, we help identify patients who may be suitable for therapies such as inclisiran—particularly those not reaching lipid targets, or not tolerating first-line treatments such as statins, ezetimibe, or bempedoic acid, in line with national guidance. Working collaboratively with practices, we support clinical decision-making, streamline initiation pathways, and ensure appropriate coding, monitoring, and follow-up. For patients in the primary prevention category, we also provide lifestyle advice and signposting to local services. This supports the national aim of reducing cardiovascular risk through proactive, community-based care.

Availability Through Primary Care and Community Pharmacy

Inclisiran can be purchased by community pharmacies and general practices for a nominal fee. NHS England has confirmed that appropriate reimbursement mechanisms are in place, enabling wider access and encouraging uptake through local care systems. This supports the NHS’s ambition to enhance care in community settings and reduce pressures on secondary care services.

Changes in Prior Approval Requirements

NHS England has removed the requirement for prior approval in secondary care for inclisiran use. This change brings secondary care prescribing into line with primary care access, reducing administrative barriers and facilitating timely treatment initiation across settings.

Conclusion

This update from NHS England reflects a continued commitment to improving lipid management and cardiovascular outcomes. By securing long-term access to inclisiran and simplifying prescribing processes, the NHS is supporting integrated, community-based approaches to cardiovascular disease prevention.

Citation:
NHS England. (2024, March). CVD Prevention: Lipid Management – Inclisiran. NHS England.