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Could aspirin help ease the pain of the 'credit crunch'?

David Nicholson highlights the challenging financial climate facing the NHS over the next five years. In addition, the NHS Confederation have asked whether dealing with the financial downturn is the 'greatest ever leadership challenge for the NHS?'.

The NHS Confederation has identified the need for 'courageous decisions' to be made during the ‘credit crunch’. Within these difficult economic times, in which new medicines and devices are likely to bring further cost pressures, it is important to maximise the benefits of existing low-cost interventions.

Aspirin is a readily available medicine that is inexpensive. The increased use of low-doses of the medicine in the population could lead to reductions in the number of cases of heart attacks, strokes and possibly cancer. These benefits could save substantial health and social care resources although there would also be an increase in the number of undesirable effects from aspirin, such as bleeding.

If 'courageous decisions' on policy are to be made during the ‘credit crunch’, then the increased use of aspirin could, alongside other public health interventions, make an important contribution to both the control of disease and reducing cost pressures. This might also lead to paradigm shift in policy, namely moving resources from expensive treatment towards a preventive agenda which empowers informed choice and self-care. Such a shift might also bring into question the role of combined medications, such as the 'polypill', in which the pharmaceutical industry will have an interest in profit.

Before making 'courageous decisions', there may be opportunities to take an inventory of those interventions that have played an important role in delivering the objectives of the NHS. Aspirin has already made a contribution and could have a potentially increased role in future. In the US, the Agency for Healthcare Research and Quality has published healthy ageing leaflets which include the possible role of aspirin. In the UK, perhaps this might be expanded to a health education campaign on the benefits and risk of aspirin.