Local GP leaders across the south of England have told practices not to follow the NHS’s advice to prescribe the cholesterol lowering drug inclisiran because of concerns over funding and long term safety monitoring. The pushback comes amid a drive by NHS England, which published funding guidance in April 2023,1 and local integrated care boards (ICBs) to make the drug available in primary care to help tackle cardiovascular disease. The National Institute for Health and Care Excellence (NICE) approved inclisiran—made by Novartis and marketed as Leqvio—in 2021,23 hailing it as “a potential game changer in preventing thousands of people from dying prematurely from heart attacks and strokes.” Administered by injection, inclisiran uses RNA interference to boost the liver’s ability to remove low density lipoprotein cholesterol (LDL-C) from the blood. However, the BMA, the Royal College of General Practitioners,45 and experts writing in The BMJ 6 have raised concerns about inclisiran being ini