Conditions for Byetta

Status
Not open for further replies.
L

lucy123

Well-Known Member
Relationship to Diabetes
Type 2
Hi,

When I have seen the consultant he has been really frustrated that he is not able to put me on Byetta as I only pass two out of so many conditions for prescribing it - and I need to pass three - I think because my hba1c was too good it meant he couldn't prescribe. However the consultant just knows it will be good for me - but he can't win the case with the PCT.

I have looked all over to find out what the NICE conditions are but can't find them. I am looking for a quick bullet point, easy to understand document that says simply what the conditons are.

Can anyone help?🙂
 
Hi Lucy

Sorry I can't help with the list of conditions - I would be interested to read them too.

I saw our practice nurse last night and explained I'm not feeling that much better than when I started, and she asked if anyone had broached the subject of what happens when the tablets dont work. I said I had read about Byetta, and she seemed to think this would be good for me.

I have an appointment with the DSN next week to discuss.

Hopefully I meet some of the criteria!!!
 
Emmaathome said:
Hi Lucy

Sorry I can't help with the list of conditions - I would be interested to read them too.

I saw our practice nurse last night and explained I'm not feeling that much better than when I started, and she asked if anyone had broached the subject of what happens when the tablets dont work. I said I had read about Byetta, and she seemed to think this would be good for me.

I have an appointment with the DSN next week to discuss.

Hopefully I meet some of the criteria!!!
Click to expand...

I think one of the criteria is HBA1c must be over 7.5% which I am well below.
 
I am waiting for an appointment from the hosp so I can start on Byetta.
I was told my BMI would qualify me...don't know if that's on it's own, or along with other criteria too. So I will be very interested to see what happens.
I haven't had my A1c tested yet...and don't know if I need this doing before the hosp app.

I am going away in 4 weeks, and was hoping to get this all arranged and started before I go..I just want to feel better!

Has the doc/nurse given you any indication on how long this all takes?
 
Found this - not sure if it helps taken from http://www.nice.org.uk/nicemedia/pdf/CG87ShortGuideline.pdf


Recommendation 1.1.14
Consider adding a GLP-1 mimetic (exenatide) as third-line therapy to first-line metformin and a second-line sulfonylurea when control of blood glucose remains or becomes inadequate (HbA1c ≥ 7.5%, or other higher level agreed with the individual) and the person has:
? a body mass index (BMI) ≥ 35.0 kg/m2 in those of European descent (with appropriate adjustment for other ethnic groups) and specific psychological or medical problems associated with high body weight, or
? a BMI < 35.0 kg/m2 and therapy with insulin would have significant occupational implications or weight loss would benefit other significant obesity-related comorbidities.
Recommendation 1.1.15
Only continue GLP-1 mimetic (exenatide) therapy if the person has had a beneficial metabolic response (a reduction of at least 1.0 percentage point in HbA1c and a weight loss of at least 3% of initial body weight at 6 months).
Recommendation 1.1.16
Discuss the potential benefits and risks of treatment with a GLP-1 mimetic (exenatide) with the person to enable them to make an informed decision.

Thats me out too - BMI not high enough.
 
Doddy said:
I am waiting for an appointment from the hosp so I can start on Byetta.
I was told my BMI would qualify me...don't know if that's on it's own, or along with other criteria too. So I will be very interested to see what happens.
I haven't had my A1c tested yet...and don't know if I need this doing before the hosp app.

I am going away in 4 weeks, and was hoping to get this all arranged and started before I go..I just want to feel better!

Has the doc/nurse given you any indication on how long this all takes?
Click to expand...



BMI was one of the other conditions too. I also thing BP was (but mine is fine). Is your hba1c likely to be over 7.5%? If not I was led to believe that is the first condition - below that and no further. If above 7.5% then you have to hit 2 more out of about 5 conditions. I think I hit 3 but my hba1c is only 6% so I was automatically refused by PCT. My only concern is my hypos affect my true hba1c level but no one is listening! 🙄
 
Hi Doddy

If they have told you your appointment relates to starting you on Byetta, sounds like it should be quick for you.

My appointment next week is to have a chat and discuss - I won't start next week due to my upcoming holiday - the nurse said they are unlikely to do anything before my hols. Of course, if my other meds kick in they won't need to do anything further!!!

Good luck - hope you get sorted for your holidays!!!
 
Emmaathome said:
Hi Doddy

If they have told you your appointment relates to starting you on Byetta, sounds like it should be quick for you.

My appointment next week is to have a chat and discuss - I won't start next week due to my upcoming holiday - the nurse said they are unlikely to do anything before my hols. Of course, if my other meds kick in they won't need to do anything further!!!

Good luck - hope you get sorted for your holidays!!!
Click to expand...

I am sure they will sort you Doddy.

Can I ask do either of you mind sharing what your hba1c is?
 
On diagnosis it was 10.6%, latest one (a couple of weeks ago was 9.something).

My BMI is 26, and I have started Ramipril (?) for my blood pressure.

Not sure if those things are enough....
 
Emmaathome said:
On diagnosis it was 10.6%, latest one (a couple of weeks ago was 9.something).

My BMI is 26, and I have started Ramipril (?) for my blood pressure.

Not sure if those things are enough....
Click to expand...


I would think they are Emma - I just can't find where the list of conditions are but I think the major one is the hba1c being over 7.5%. I hope this really works for you.🙂
 
Emmaathome said:
Found this - not sure if it helps taken from http://www.nice.org.uk/nicemedia/pdf/CG87ShortGuideline.pdf


Recommendation 1.1.14
Consider adding a GLP-1 mimetic (exenatide) as third-line therapy to first-line metformin and a second-line sulfonylurea when control of blood glucose remains or becomes inadequate (HbA1c ≥ 7.5%, or other higher level agreed with the individual) and the person has:
? a body mass index (BMI) ≥ 35.0 kg/m2 in those of European descent (with appropriate adjustment for other ethnic groups) and specific psychological or medical problems associated with high body weight, or
? a BMI < 35.0 kg/m2 and therapy with insulin would have significant occupational implications or weight loss would benefit other significant obesity-related comorbidities.
Recommendation 1.1.15
Only continue GLP-1 mimetic (exenatide) therapy if the person has had a beneficial metabolic response (a reduction of at least 1.0 percentage point in HbA1c and a weight loss of at least 3% of initial body weight at 6 months).
Recommendation 1.1.16
Discuss the potential benefits and risks of treatment with a GLP-1 mimetic (exenatide) with the person to enable them to make an informed decision.

Thats me out too - BMI not high enough.
Click to expand...

Really sorry - completely missed this! Does this mean there are only 2 conditions then? Hba1c and BMI - I am sure there were more when the consultant went over it with me.
 
Thank you!!!

I hope you get sorted too!!
 
I don't know what the HBA1c is..it's not been tested yet. However, all my readings have been pretty high, and if i do the formula thingy someone has mentioned on another forum, it comes out pretty high! I have an app that i record all my readings on, and my average BS reading is now at 16.4, so if that is anything to go by, I reckon it will be high enough to qualify. I did get the impression from the GP that my BMI alone would qualify me...she didn't even want to do a fasting BG as my levels are high anyway.

It really annoys me how you have to qualify for things...you could be just out of the range for help, but they know the drug would help you, yet they give it as you are 0.1 within the range. I know the NHS can't afford to give it to all, but even so, if the drug will help, it should be prescribed.
 
lucy123 said:
Really sorry - completely missed this! Does this mean there are only 2 conditions then? Hba1c and BMI - I am sure there were more when the consultant went over it with me.
Click to expand...

Not sure - it was the only thing I could find with any sort of "guidance".

I'll keep searching!!!
 
Aside from T2, I find it very frustrating that Byetta isn't ever prescribed for T1s.

Exendin-4 (Byetta) has been proven to reverse T1 diabetes in mice when used in conjunction with another medication, lisofylline. Lisofylline is also already approved for human use.

In any case, Byetta also means that T1s get the full spectrum of things they're missing. If you have T1, it's not just insulin you're lacking. You also don't produce c-peptide or amylin. Amylin regulates the conversion of protein to glucose and plays an important role in preventing hunger. C-peptide appears to promote vascular flexibility, reducing retinopathy, hypertension and CVD...which just happen to be some of the more common complications of T1.

Yet T1s aren't allowed near Byetta and you can't even get it prescribed privately.
 
DeusXM said:
Yet T1s aren't allowed near Byetta and you can't even get it prescribed privately.
Click to expand...

I too tried to get it prescribed privately but the answer from the head of the PCT was a clear NO!
 
DeusXM said:
Aside from T2, I find it very frustrating that Byetta isn't ever prescribed for T1s.

Exendin-4 (Byetta) has been proven to reverse T1 diabetes in mice when used in conjunction with another medication, lisofylline. Lisofylline is also already approved for human use.

In any case, Byetta also means that T1s get the full spectrum of things they're missing. If you have T1, it's not just insulin you're lacking. You also don't produce c-peptide or amylin. Amylin regulates the conversion of protein to glucose and plays an important role in preventing hunger. C-peptide appears to promote vascular flexibility, reducing retinopathy, hypertension and CVD...which just happen to be some of the more common complications of T1.

Yet T1s aren't allowed near Byetta and you can't even get it prescribed privately.
Click to expand...


It's madness, but i suspect it comes down to the good old money argument.
 
Well it does cost an arm and a leg - ?68.24 for a 60-dose pen. I assume it's 2 a day bearing in mind you have to lob it after 30 days! LOL

But aren't guidelines only guidelines? None of the NICE Guidelines are graven in stone!

And for those of us with the dead Beta cells, and also those of us totally without a pancreas - there is a company currently trying to bring on a commercial C-peptide jab.
 
lucy123 said:
Hi,

When I have seen the consultant he has been really frustrated that he is not able to put me on Byetta as I only pass two out of so many conditions for prescribing it - and I need to pass three - I think because my hba1c was too good it meant he couldn't prescribe. However the consultant just knows it will be good for me - but he can't win the case with the PCT.

I have looked all over to find out what the NICE conditions are but can't find them. I am looking for a quick bullet point, easy to understand document that says simply what the conditons are.

Can anyone help?🙂
Click to expand...

The general criteria is that you have to have maxed out on Metformin and Gliclazide and still be poorly controlled (A1c over 7.5).
 
Just back from my Xpert course - the DSN running it works with the DSN i'm seeing on Monday night. She has confirmed I wont qualify for Byetta as i would need a higher BMI.

So will see what she says on Monday - I have been for my blood taking this morning, so at least she will have up to date results when I see her.
 
Status
Not open for further replies.
Back
Top