Working in partnership with the AAC and NICE

There are a range of medicines that people with elevated blood cholesterol can take to help reduce the risk of cardiovascular disease (CVD). We are working in partnership with the Accelerated Access Collaborative (AAC) and the National Institute for Health and Care Excellence (NICE) to ensure appropriate prescribing of all medicines on the lipids management pathway, alongside other factors such as lifestyle changes. The medicines that form the NICE and AAC recommended prescribing pathway for people with high cholesterol levels include bempedoic acid, ezetimibe, high intensity statins, inclisiran, PCSK9i, and statins.

A key ambition for the Health Innovation Network’s lipids programme is to ensure patients are prescribed the most appropriate medicine in a shared decision with their clinician.

You can see a summary of national guidance for lipid management on the AAC website.

Lipid management pathways for primary care and secondary care clinicians

Lipid management in England must improve to drive better CVD outcomes and, to address the clinical priority of improved lipid management, two pathways – one for acute cardiovascular disease in secondary care and one for primary care clinicians – have been developed to provide clear and simple guidance for clinicians on how optimal lipid management may be achieved and provide an additional resource to support patient management. Click the links below which take you to these two pathways. These pathways have been updated in June 2024 to take account of the Cardiovascular disease: risk assessment and reduction, including lipid modification guidance.

Lipid optimisation pathway following an acute cardiovascular or peripheral arterial disease event

Lipid optimisation pathway for secondary prevention in primary care/the community

The pathways provide an additional resource which can be used to support patient management. They have been developed to support healthcare professionals in implementing NICE and other relevant evidence in lipid management in secondary prevention. These are not comprehensive clinical guidelines setting out all clinical scenarios, nor do they seek to set out the clinical evidence base for interventions which is covered in the relevant NICE Technology Appraisals.

Novel therapies

During 2021, NICE recommended two novel therapies for patients with elevated cholesterol as part of the lipids management pathway: bempedoic acid. An overview of the collaboration between NHS England and Novartis Pharmaceuticals for the addition of inclisiran to the lipids management pathway is available on the AAC’s webpage.