De l'inapplicabilite de certaines recommandations therapeutiques en pratique: l'exemple du remboursement des medicaments hypolipidemiants en Belgique.

International guidelines from the Task Force of European and other Societies on Coronary Prevention and national guidelines from the Belgian Lipid Club recently emphasized the potential interest of adequate management of patients with even moderate hypercholesterolaemia. However, current criteria for the reimbursement of lipid-lowering drugs in Belgium do not allow to follow these guidelines. A solution should be urgently found in order to bridge the gap and permit practitioners, after diet failure, to effectively prescribe lipid-lowering agents in patients who should benefit in priority of such a treatment. It is certainly the case in secondary prevention as well as, in high risk individuals, in primary prevention, i.e. in situations where these drugs have provided enough evidence of their efficacy with an acceptable cost-benefit ratio.