Dr Trevor Mudge, AMA Vice President, with Clive Robertson, Radio 2SM

A statin is the chemical which lowers your cholesterol, works very well. Now with the Federal Government talking about deciding who is going to be on it, the figure - your cholesterol should be about 5.3 or less, right, ideally.

If you're at seven should you have the statin or should it be a dietary thing, if it goes to nine or whatever.

Since there's this debate out there, we thought it behoves us to have a look at this in case you decide 'oh, well perhaps I shouldn't, you know, get these pills' or whatever.

Doctor Trevor Mudge is the Vice President of the Australian Medical Association. Good morning, Sir.

MUDGE: Good morning, Clive.

ROBERTSON: So I'm on the statin, mine's down to about four, which is good. I can't remember what my original figure was.

Now, you're probably privy to this debate going on re Doctor Wooldridge. Other people say that this - someone said this an incredible thing for a Health Minister to say, talking about at what stage you should or should not have the statin.

In your understanding, what figure and what circumstances should someone be on a chemical to lower cholesterol?

MUDGE: Well, I think if you're cholesterol was nine, then a statin would do you a whole pile of good. If your cholesterol was 6.5, a statin would do you a little bit of good.

It is a continuum, Clive, and that's the problem. I guess what the Health Minister is saying is that the taxpayer's only going to fund a reduction in your risk of heart disease if your risk is big.

If your risk is only little then you have to pay for it yourself.

ROBERTSON: And what's wrong -

MUDGE: Is that what he's saying?

ROBERTSON: Yes, but, I mean, what's wrong with paying for yourself anyway. I don't have a problem with that?

MUDGE: No and neither should you. I think that the debate that society needs to have is what level of reduction risk do we wish to pay for and that's right and proper.

But the science of it has got to be right. Now, the problem that this Health Minister is getting himself into is that he's isolating himself by not, by refusing to listen to bad news so that he doesn't talk to the AMA. He changes the people on the Pharmaceutical Benefits Advisory Committee because he doesn't like to hear independent advice.

Now, this is a problem really, you can't make fully informed decisions if you isolate yourself from independent advice.

ROBERTSON: And indeed you share the load. If you say we got it wrong, I spoke to the appropriate people, the AMA people and what have you. Surely that shares a load, in which case, then, as you say, you don't isolate yourself and the errors are shared.

I mean you can say we tried again. I would think that's the way an adult would behave. You know, two minds are better than one.

MUDGE: Absolutely, you would think so.

ROBERTSON: Yes. So, what should people who are on statin's and are perhaps having financial problems or they think 'oh, well, I don't need that, now I can probably keep it down if it's about 7'. I mean, is the cardiologist or the GP right or wrong, is this a question of debate?

Should the patient debate this thing, what should they do now there's this new information coming along, which might confuse the issue.

MUDGE: Oh, well I think they need to listen to their doctors who'll be able to give them advice in their own particular circumstances.

Of course, lowering your fats is only, as you rightly point out, one of the things you can do to reduce your risk.

I mean diet, exercise, all of those other things are important. You can't change your genes.

As you point out, if you've got a genetic predisposition and you can't get your fats down with diet and exercise then you certainly need the statin.

The statin's have been one of the most widely studied drugs. I mean, the science of the improvement in your risk of heart disease is really very solid indeed and widely studied.

The problem is, of course, they're very expensive so that with a PBS budget that's going up by 15 per cent a year, it's very tempting for the Department of Health and the Minister to look to try and reduce it and in many ways it's right and proper but one, the science needs to be right and two, you need to be honest with the population and not say things like 'well, the statin's aren't going to do you any good unless your cholesterol's above nine'.

ROBERTSON: But this wouldn't be the first time that doctors have disagreed. Now, I know that, I mean, Doctor Wooldridge is, I mean he's a Health Minister, but he's also a doctor and I dare say he has his views too.

Could it just be that there's a differing of opinion, that he may be one of those that believes what he is saying. He could be of that group of doctors.

MUDGE: Well, neither Doctor Wooldridge or I are experts in the science of statin. But, I've taken expert advice about it, Doctor Wooldridge needs to take expert advice about it.

Of course the science is continually changing. There are big, large studies being published every year which will change the interpretation of exactly what the level is.

All I'm saying is that the science needs to be independent and it needs to be listened to.

ROBERTSON: Yes. And there needs to be a consensus too, as much as it can be, thank you sir, I do appreciate your time on this day.

MUDGE: You're welcome, Clive.

ROBERTSON: Thank you. Doctor Trevor Mudge, Vice President of the Australian Medical Association. I thought he phrased it rather well, didn't he.

Ends