Insulin without prescription?

[Bronco Billy]

Given that it’s a potentially lethal drug and we live in an era that doesn’t allow children to play conkers anymore for fear of injury and a resulting lawsuit, I can’t see it happening.

 

[Amity Island]

Given that it’s a potentially lethal drug and we live in an era that doesn’t allow children to play conkers anymore for fear of injury and a resulting lawsuit, I can’t see it happening.

Hi Bronco Billy, I don't think my question came across as it was written. Nothing would change, insulin would still only be given to diabetics that self manage as it is now, it would just take some pressure of GP's who must be writing the same prescription out, over and over again for the same insulin.

 

[Amity Island]

Hopefully not, in the wrong hands its a dangerous drug, even experienced user can make mistakes with consequences.

Remember what Beverley Allitt did to those poor children, she was a nurse who had access to insulin, obviously she was mentally deranged and a wicked evil woman, but who knows what could happen if someone similar got their hands on insulin with the intentions to harm or kill.

Hi nonethewiser, I am asking about if you're Type 1 and are under the care of a hospital diabetes centre.

 

[Northerner]

Hi nonethewiser, I am asking about if you're Type 1 and are under the care of a hospital diabetes centre.

It's ok, I understand what you are saying 🙂 It does seem odd that we need this 'middleman' whose only role is to dish out the prescription 🙂

 

[Amity Island]

You've got it! Precisely what I was pointing towards🙂.
I just thought the fact insulin is something we are going to need indefinitely, why not allow us to manage it ourselves, pick our insulin up without the need for the middle man.
Strictly speaking, doctors prescribe drugs, my understanding of insulin is it is a hormone and not a drug?

 

[Docb]

Maybe you should look at this issue from the point of view of the pharmacist. In the modern world they, like many other professionals, have to cover their backside. Somebody rolls up to their counter asking for insulin - how can they be sure that the individual is going to use it for the purpose intended and knows how to use it? Not a problem for regulars but if they refuse to serve somebody who needs it or serves somebody who is going to abuse it, then they will be pilloried. Do something right a million times and you won't get a thank you but get it wrong once and you will be headline news and up to your neck in lawyers trying to rob your insurance company.

If you are going to move away from the current system then something would have to be put in place to safeguard the pharmacist and I suspect that it would be more complicated and less secure than the current system. Ordering stuff from your GP on line via emis and all the middle man has to do is to approve it to be sent on to a predetermined pharmacist to have the stuff ready for collection. Not a big burden for the "middleman."

 

[Amity Island]

Maybe you should look at this issue from the point of view of the pharmacist. In the modern world they, like many other professionals, have to cover their backside. Somebody rolls up to their counter asking for insulin - how can they be sure that the individual is going to use it for the purpose intended and knows how to use it? Not a problem for regulars but if they refuse to serve somebody who needs it or serves somebody who is going to abuse it, then they will be pilloried. Do something right a million times and you won't get a thank you but get it wrong once and you will be headline news and up to your neck in lawyers trying to rob your insurance company.

If you are going to move away from the current system then something would have to be put in place to safeguard the pharmacist and I suspect that it would be more complicated and less secure than the current system. Ordering stuff from your GP on line via emis and all the middle man has to do is to approve it to be sent on to a predetermined pharmacist to have the stuff ready for collection. Not a big burden for the "middleman."

Thanks Doc B for your reply, I appreciate that.
Insulin would still be under the direction of a consultant at the diabetes centre, only difference would be that there would be no need for the constant issue of prescriptions from the g.p. thus only people going to see a pharmacist for insulin would be those already under the care of a consultant. I was thinking of a diabetic I.D card.

 

[Docb]

It might work but again, in the modern world, you don't need a system that is simple for sensible people to use. What you need is a system that stops the odd complete idiot getting hold of insulin for nefarious puposes. A diabetic ID card makes a lot of sense for more than just getting insulin but quite what it would look like and how it would be administered is far from straight forward. Its not the technology, that's trivial. Getting all interested parties to agree on it would be harder than organising Brexit.

 

[Bruce Stephens]

What you need is a system that stops the odd complete idiot getting hold of insulin for nefarious puposes.

Not just that, you need to account for the insulin. Since the pharmacy has to pay for it, someone needs to pay them. And someone needs to pay that someone and so on up to (presumably) the NHS.

It does feel like the current system could be simplified (reducing the tedious work that GPs do authorising repeat prescriptions), but I fear whatever it would end up as would still be basically some variant of a prescription.

 

[trophywench]

Sooooo - are we also doing this with test strips since even if a T1 under the care of a hospital D clinic isn't on any other drugs for anything else, he/she will absolutely need a regular supply of test strips and/or Libre sensors. Where do you draw the line?

 

[nonethewiser]

Hi nonethewiser, I am asking about if you're Type 1 and are under the care of a hospital diabetes centre.

Lets face it, if your proposal went ahead then everyone would want to be under the care of a hospital diabetes clinic, fair enough it would reduce the gp's workload but your just shifting that workload to the hospitals clinic which are already overstretched.

Not forgetting the discrimination aspect, why just type 1's and not type 2's for example. Not being picky you understand.

 

[AndBreathe]

Personally, I think an on-demand system would lead to increased dispensing.

Of course, many T1s treat their insulin as a precious substance, and as a life preserver that's understandable, but in this throw away culture, if something is free, it is worthless.

Of course, in UK insulin is dispensed free anyway, but there is a check in place to ensure it isn't being disposed willy-nelly because folks aren't taking adequate care or whatever.

Of course, I am expressing that very clumsily, but if you go to an all you can eat buffet or on an all inclusive holiday, I'd wager the amount of waste is higher than if individuals are paying per unit of food/drink or whatever.

 

[Northerner]

Personally, I think an on-demand system would lead to increased dispensing.

Of course, many T1s treat their insulin as a precious substance, and as a life preserver that's understandable, but in this throw away culture, if something is free, it is worthless.

Of course, in UK insulin is dispensed free anyway, but there is a check in place to ensure it isn't being disposed willy-nelly because folks aren't taking adequate care or whatever.

Of course, I am expressing that very clumsily, but if you go to an all you can eat buffet or on an all inclusive holiday, I'd wager the amount of waste is higher than if individuals are paying per unit of food/drink or whatever.

I don't quite see that, there's nowt you can do with insulin that's wasteful It shouldn't be overlooked, of course, that there are at least twice as many Type 2s on insulin as Type 1s in the UK (I seem to remember the numbers being in the region of 900k Type 2 and 420k Type 1). I suppose that the one possibility is that someone might get more than they need and then flog it to the Yanks! 😱 😉

It's an interesting proposition @Amity Island, and I guess that any minister thinking of putting it in place should be directed to read this thread first! 🙂

 

[Amity Island]

It might work but again, in the modern world, you don't need a system that is simple for sensible people to use. What you need is a system that stops the odd complete idiot getting hold of insulin for nefarious puposes. A diabetic ID card makes a lot of sense for more than just getting insulin but quite what it would look like and how it would be administered is far from straight forward. Its not the technology, that's trivial. Getting all interested parties to agree on it would be harder than organising Brexit.

When you think about it, the current arrangement is far more open to insulin falling into the wrong hands, anybody can collect someone's prescription! At least with an ID card, only the user/carer can collect their insulin.

 

[Amity Island]

I don't quite see that, there's nowt you can do with insulin that's wasteful It shouldn't be overlooked, of course, that there are at least twice as many Type 2s on insulin as Type 1s in the UK (I seem to remember the numbers being in the region of 900k Type 2 and 420k Type 1). I suppose that the one possibility is that someone might get more than they need and then flog it to the Yanks! 😱 😉

It's an interesting proposition @Amity Island, and I guess that any minister thinking of putting it in place should be directed to read this thread first! 🙂

Interesting! I feel that insulin for a Type 1 is an essential, just like air, water and food. Having insulin readily available at a pharmacy seems like a natural arrangement.

 

[Amity Island]

Personally, I think an on-demand system would lead to increased dispensing.

Of course, many T1s treat their insulin as a precious substance, and as a life preserver that's understandable, but in this throw away culture, if something is free, it is worthless.

Of course, in UK insulin is dispensed free anyway, but there is a check in place to ensure it isn't being disposed willy-nelly because folks aren't taking adequate care or whatever.

Of course, I am expressing that very clumsily, but if you go to an all you can eat buffet or on an all inclusive holiday, I'd wager the amount of waste is higher than if individuals are paying per unit of food/drink or whatever.

Hi, I'd use the example of water. Tap water is "free", but I don't drink any more because it's free at the tap. I only drink what I need.

 

[Amity Island]

I don't quite see that, there's nowt you can do with insulin that's wasteful It shouldn't be overlooked, of course, that there are at least twice as many Type 2s on insulin as Type 1s in the UK (I seem to remember the numbers being in the region of 900k Type 2 and 420k Type 1). I suppose that the one possibility is that someone might get more than they need and then flog it to the Yanks! 😱 😉

It's an interesting proposition @Amity Island, and I guess that any minister thinking of putting it in place should be directed to read this thread first! 🙂

I agree with you on not wasting insulin, I don't drink any more water from my tap because it's "free", I only ever drink what I need

 

[Amity Island]

Sooooo - are we also doing this with test strips since even if a T1 under the care of a hospital D clinic isn't on any other drugs for anything else, he/she will absolutely need a regular supply of test strips and/or Libre sensors. Where do you draw the line?

Hi Jenny, i'm coming from the angle of the essential, like water, air, food. I think insulin is a must for Type 1 Diabetics, just feels natural to make it readily available to them as and when required.

 

[Amity Island]

Lets face it, if your proposal went ahead then everyone would want to be under the care of a hospital diabetes clinic, fair enough it would reduce the gp's workload but your just shifting that workload to the hospitals clinic which are already overstretched.

Not forgetting the discrimination aspect, why just type 1's and not type 2's for example. Not being picky you understand.

Hi Nonethewiser, i'm interested in what you said about everyone wanting to be under the care of a hospital diabetes clinic, does this mean that there are Type 1's who don't attend hospital? I didn't know this. I mentioned Type 1's in my original post as I've always understood them to require insulin. As far as I've understood (which it looks like i'm mistaken) type 2's using insulin is a more recent occurrence? I thought type 2 meant "insulin resistance" not "lack of insulin"?? My knowledge of type 2 is not very vast...

 

[Northerner]

Hi Nonethewiser, i'm interested in what you said about everyone wanting to be under the car of a hospital diabetes clinic, does this mean that there are Type 1's who don't attend hospital? I didn't know this. I mentioned Type 1's in my original post as I've always understood them to require insulin, as far as I've understood (which it looks like i'm mistaken) type 2's using insulin is a more recent occurrence? I thought type 2 meant "insulin resistance" not "lack of insulin"?? My knowledge of type 2 is not very vast...

Many people with Type 2 progress to needing insulin - there are a lot of people with Type 2, hence the reason for the ones using insulin being much higher than the Type 1s (who all need insulin, but Type 1 is relatively rare) 🙂 Not all Type 1s are under hospital care - at my last surgery they decided to move me to GP care because my diabetes management was good and stable, although I still had 'access' to the hospital DSN and consultant should I need it. Since I moved house I have been seen at hospital clinic, but was told at my last review that they would probably be moving me to GP care. Fair enough, there's not a lot they can do for me (or need to) at the hospital.