Seriously underdiagnosed Type 2

[MikeWeatherley]

How much Metformin is costing the NHS

Mike

ISTR that according to the British National Formulary the cost of metformin is approximately 1p per tablet.

Actually, there was an article in the press on Saturday about the newly
discovered anti-cancer properties of Metformin, which claimed the pills
are 8p each. And I was put straight on three per day, after the required
blood-tests, to check that I've got no side-effects (which shows how bad
my blood-glucose was). So it makes even more suspicious the fact that
my GP had to be dragged, kicking-and-screaming, into signing my original
prescription for me (at gunpoint). I didn't even realise, at the time, that
I'd immediately qualify for 'free prescriptions' once going onto Metformin.
*HE* did, though. And as I'm now costing the NHS a cool ?80 or so a
year in tablets (according to the article) I'm glad I fought to get the
prescription before the forthcoming government reorganisation/cuts
take effect. I don't fancy anyone's chances of getting Metformin out of
my GP from now on...

 

[MikeWeatherley]

A result for diabetics with anaemia

Re: the original story at the top of this thread, after *finally* getting
the Fructosamine test from my diabetic-nurse and the Metformin from
my GP, I began a campaign of awareness for the medical complication,
by writing to the local health authority, the Department of Health, the
BMA, Stephen Dorrell MP (chair of the parliamentary select committee
reviewing Andrew Lansley's reform of the NHS - the committee actually
ruled *against* it, concluding that it would damage healthcare) and -
since they don't publicise David Cameron's email address - I wrote to
George Osborne, instead.🙂

I got a nice reply from the BMA (who license GPs to practice medicine)
asking if I wanted to complain about my GP. But as I made it clear
that I wanted no recriminations against individuals, or compensation
for myself, but simply wanted to make all professional bodies aware of
the complication which anaemia causes for diabetes diagnosis, they
gave me a few other addresses to write to as well.

I also received a belated reply from the Department of Health, letting
me know that the World Health Organisation has just issued new
guidance on the diagnosis of diabetes in patients with anaemia, and
that the DoH is currently re-writing their own guidance on the subject
for GPs in the UK. Result. 😎 Just shows what can be done if you
aren't afraid of anybody. Next stop... the bankers! 😛

Cheers,
Mike

 

[lauraw1983]

Ooops... just checked, they are actually 3.25p each! LOL!

But yes, you're right, as soon as you are on meds for diabetes it does make all your scripts free which will indeed cost the state money, but presumably you are paying NI?

Pattidevans, do you mind if I ask a question? Why/how did your diabetes take 8.5 years to diagnose as Type 1?? I ask out of curiousity about myself too.

And hello Mike, sorry you have had such a battle to get this diagnosed, you are absolutely right most of it is all about money and the recent cuts/decisions to give GP's more rights over their costs it is only going to get worse. (In England and Wales - I am in Scotland so for now it doesn't affect me the same) so wrong, yet so common. 😡

 

[AlisonM]

Laura, I'm just guessing but perhaps Patti was in the same boat as me. I was initally diagnosed as T2 when I'm a LADA or T1.5 which is slow onset T1. It can be quite a battle and can take years to get the right diagnosis. There are tests that can establish which form of Diabetes you have but, depending on age, the medical profession will often make assumptions and decide that if you're over 40 you're T2.

 

[lauraw1983]

Laura, I'm just guessing but perhaps Patti was in the same boat as me. I was initally diagnosed as T2 when I'm a LADA or T1.5 which is slow onset T1. It can be quite a battle and can take years to get the right diagnosis. There are tests that can establish which form of Diabetes you have but, depending on age, the medical profession will often make assumptions and decide that if you're over 40 you're T2.

Hmm this is what I was wondering. Are the tests the antibody and c-peptide ones??

 

[Mark T]

Hmm this is what I was wondering. Are the tests the antibody and c-peptide ones??

Yes, I had Glutamic Acid Decarboxylase (GAD) Antibodies and Islet Cell Antibodies (ICA) tested to exclude me from being a Type 1/Type 1.5

Although there are other antibodies they can also test for (which I can't recall off the top of my head) but those are apparently less common.

They also do a urine c-peptide test - which is a much easier option because I think for a proper C-peptide test it is an in-patients test.

 

[Ellie Jones]

It's interesting, but I've got another perspective on the subject of
NHS reluctance to prescribe medicines, as my employer is actually
a drugs company. No names, no pack-drill (I'm not advertising) but
15 years ago, we developed an Alzheimer's drug which was a virtual
cure, allowing people to remain at home and live a normal life. But
NICE (or 'Not-So-Nice', as I prefer to call them) refused to allow GPs
to prescribe it on the NHS, due to cost. I think that a single tablet
a day would have been about ?1. That's ?7 a week. And if you
compare that with having to put someone in a nursing-home, because
they can no longer even remember their own name, you're looking at
almost 100x that amount. I mean, the facts speak for themselves,
yet try getting NICE to see reason...

Sorry I know these drugs and they do cost more than a ?1 a day, they actually range around the ?3 a day mark (today prices).. There are about 4 types available but all are around similar price tag..

GP's are not allowed to instigate the treatment, this has to be done by the Mental Health team once it's instigated then the GP can issue the prescription. And these drugs are very beneficial when they are introduced at the right time, but sadly they do lose their effect long term as they only slow the progress of the disease down not stop it in it's tracks... How long a patient will benefit is based on two factors, at what point it was introduced and what route the progression follows (what parts of the brain is destroyed first)

I assume that NICE has changed it's guidelines concerning these drugs, as more and more people are being prescribed them.

The NHS accountants don't see past the 5th of April in any one year! And books have to be balanced for then... Which can pose problems for the patient indeed..

With NICE yes it can seem callous at times with it's decisions but that's because it's bases it's decision on a total clinical view of total benefits/out comes costs rather than a individual patient level. Another aspect of NICE which a lot of people don't realise, is that on occasions they have got manufacturers to reduce the costs..

With that said I do agree that the problems with your doctor not doing the right tests for proper control and treatment of your diabetes, I do feel that this is problem down to his actual ignorance of correct test procedures in your individual case rather than a penny pinching mission though..

And I do agree that NHS accountants are often two busy balancing this years books, rather than seeing the long term cost effectiveness of some of the more expensive treatments...