Insulin costs and CGMs

[DouglasXKR]

An American study gave a typical cost of £100 per lantus (insulin glargine) pen and noted the horrendous inflation in insulin costs in the last 5 years - over 500%. Does anyone know what we or our GPs pay for insulin in the UK?

I ask this because in the period I have been using a Libre2, I have reduced my insulin consumption (basal and bolus) by £300 per month (at these prices) by better management and I’m looking for reasons why my GP practice shouldn’t fund the libre2 at £100 per month.

 

[rebrascora]

I believe it is about £40 for a pack of 5 pens here in the UK.... I stand to be corrected though. The prices in the USA are totally shocking for such a life supporting medication.

As regards Libre, there are new NICE guidelines coming out soon (April possibly) which will advise that all Type 1 diabetics should get access to Libre or other CGM on prescription. I think many GPs are unable to prescribe it themselves and it would need to be authorized by a consultant, so you probably need to ask for a referral to the diabetes clinic to get it on prescription if you are not currently under their care. You could perhaps ring your diabetes clinic helpline and leave a message and see if you can get it sorted that way via telephone rather than waiting for the referral and appointment which with current backlogs could take some time.

 

[Robin]

An American study gave a typical cost of £100 per lantus (insulin glargine) pen and noted the horrendous inflation in insulin costs in the last 5 years - over 500%. Does anyone know what we or our GPs pay for insulin in the UK?

I ask this because in the period I have been using a Libre2, I have reduced my insulin consumption (basal and bolus) by £300 per month (at these prices) by better management and I’m looking for reasons why my GP practice shouldn’t fund the libre2 at £100 per month.

The British National Formulary has all the current prices. I just happened to land on the Novorapid and Fiasp page, but it will all be there. Looks like the Aspart family are round about £28 for a pack of 5 Novorapid or Fiasp cartridges, @rebrascora , with the prefilled pens being a couple of pounds dearer. Interesting, because I always thought they were the same price.

Medicinal forms | Insulin aspart | Drugs | BNF content published by NICE

Pricing and pack information for Solution for injection forms of Insulin aspart

bnf.nice.org.uk

 

[Robin]

Levemir is £42 for 5 cartridges, I hadn’t realised it was more expensive.

Medicinal forms | Insulin detemir | Drugs | BNF content published by NICE

Pricing and pack information for Solution for injection forms of Insulin detemir

bnf.nice.org.uk

Lantus and the biosimilars, Semglee and Abasalgar, are all the same price, at around £35.

Medicinal forms | Insulin glargine | Drugs | BNF content published by NICE

Pricing and pack information for Solution for injection forms of Insulin glargine

bnf.nice.org.uk

 

[Robin]

Doing the calculations on my insulin needs, (which I know are quite low) I believe the Libre costs the NHS around £35 a sensor, so I’m using £70 a month on monitoring (plus the cost of a few test strips) and £20 a month on insulin.

 

[DouglasXKR]

I believe it is about £40 for a pack of 5 pens here in the UK.... I stand to be corrected though. The prices in the USA are totally shocking for such a life supporting medication.

As regards Libre, there are new NICE guidelines coming out soon (April possibly) which will advise that all Type 1 diabetics should get access to Libre or other CGM on prescription. I think many GPs are unable to prescribe it themselves and it would need to be authorized by a consultant, so you probably need to ask for a referral to the diabetes clinic to get it on prescription if you are not currently under their care. You could perhaps ring your diabetes clinic helpline and leave a message and see if you can get it sorted that way via telephone rather than waiting for the referral and appointment which with current backlogs could take some time.

Thank you. The article told of USA folk going to Canada where it’s a lot cheaper and a case of a 25 yr old who lost the protection of his mother‘s health care plan, reduced the required dose to save money and which is thought to have killed him.

b*gger I thought I was on a winner there … you are correct about the consultant. My gp practice booked an appointment for that purpose and the earliest was 60 days here in Oxford.

 

[helli]

As regards Libre, there are new NICE guidelines coming out soon (April possibly) which will advise that all Type 1 diabetics should get access to Libre or other CGM on prescription.

This would be great but given the reason these guidelines have not been published yet is that they are draft and going through review.
So stating this as fact may be a tad presumptuous. There is still time for it to change ... and it is only a guideline so may be applied differently in different ccgs.
I think this only refers to England.

(Sorry being pedantic again but falsely raising hopes can be troublesome.)

 

[trophywench]

True @helli - but @DouglasXKR is likely to have success with the hospital diabetes clinic, I'd like to think - I always have in both Worcestershire and Warwickshire - and I've told you I dunno how many times that Cov CCG are as mean as hell!

 

[DouglasXKR]

@DouglasXKR, have you taken advantage of the free trial sensor offer, run by Abbot? It could give you a taste before the 6 week appointment.

yes

 

[everydayupsanddowns]

I ask this because in the period I have been using a Libre2, I have reduced my insulin consumption (basal and bolus) by £300 per month (at these prices) by better management and I’m looking for reasons why my GP practice shouldn’t fund the libre2 at £100 per month.

Have you checked the NHS England Mandatory Libre Criteria @DouglasXKR

In general, if you need to check BG 8 times a day (eg before each meal to calculate doses, and before bed for safety, plus a driven journey or two and a couple of hypo checks), then it is cost effective to offer you Libre funding. There are other indications that can also secure funding too. The full criteria are here:

https://www.england.nhs.uk/wp-content/uploads/2019/03/National-arrangements-for-funding-of-relevant-diabetes-patients-June-2020-Updated-final.pdf