The introduction of Inclisiran (Leqvio®) into the lipid management pathway has created an exciting opportunity for primary care to reduce cardiovascular risk through a convenient, biannual injectable therapy. But as Inclisiran gains traction, many practices are asking the same question: should we prescribe it via the pharmacy or buy it in and administer it ourselves?
Let’s explore the practical, financial, and clinical arguments — and make the case for why buying it in is the better option for practices, patients, and population health outcomes.
🧾 Prescription vs. Personally Administered: What’s the Difference?
There are two main routes for prescribing Inclisiran in primary care:
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Standard FP10 Prescription to Pharmacy
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The patient collects the drug from a community pharmacy.
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The prescription must be generated at least 72 hours in advance.
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Patients may incur a prescription charge.
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The responsibility for correct storage and transport shifts to the patient.
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There’s a risk of missed or delayed administration if the patient forgets the medicine or self-administers incorrectly.
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Buy-In and Administer In-House
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The practice orders Inclisiran from AAH at a nominal charge of £45 + VAT.
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Administered directly by a healthcare professional in the surgery.
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No prescription charge applies to the patient.
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Income is claimed via FP10 and FP34PD submission (as a personally administered item).
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Reimbursed at £60 from 1 April 2025.
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From October 2024, no clawback (discount deduction) is applied.
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💸 The Financial Case
Practices ordering Inclisiran as a personally administered item will generate a margin of £15 per dose (plus VAT reimbursement) — a straightforward, predictable income stream.
In contrast, prescribing via FP10 for community pharmacy offers no financial benefit to the practice. Worse, it risks incurring additional work if patients fail to collect or store the medication appropriately.
This isn’t a complex commissioning landscape — the cost of Inclisiran is centrally funded by NHS England, with ICBs covering the reimbursement of £60 per dose from their prescribing budgets. The difference between the nominal charge (£45) and the reimbursement rate is essentially a built-in margin for practices choosing the PA route.
🛡️ Clinical & Operational Risk Management
Let’s be blunt: sending patients to collect Inclisiran introduces clinical risks and operational headaches.
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Can we guarantee temperature control maintenance from the pharmacy to the practice?
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What happens if the patient forgets their injection at home or arrives with tampered packaging?
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Do we want to risk self-administration or confusion around timing?
By administering Inclisiran in-house, we maintain full clinical oversight and safeguard against these variables. It’s the same logic we use for other high-value injectables like Prolia (denosumab) — control equals quality.
📈 Linking to QOF: Cardiovascular Disease 2025/26
The 2025/26 Quality and Outcomes Framework (QOF) update introduces a sharper focus on cardiovascular risk reduction. The new indicators reward:
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Optimisation of lipid management for patients with established CVD.
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Appropriate use of non-statin therapies when statins alone are insufficient or not tolerated.
Inclisiran slots perfectly into this landscape: a biannual injection supporting LDL-C reduction in high-risk patients — particularly those who are non-adherent or intolerant to statins. Buying it in allows practices to proactively manage patients through recall systems, rather than reacting to fragmented prescribing journeys through pharmacy.
🔚 Conclusion: Keep it In-House, Keep it Simple
GP practices should be confident in buying in Inclisiran directly and administering it under the personally administered route. It’s more efficient, safer, better for patient experience, and contributes to practice income — all while aligning with the national cardiovascular prevention strategy.
Now is the time to embed Inclisiran into your lipid management protocols and QOF-driven recall systems.