Some statistics on NHS prescribing 2005/6 to 2010/11

[Northerner]

The NHS Information Centre has published a report on the cost of prescribing for diabetes in England over the period 2005/2006 to 2010/2011.



Some of the following key results have been presented (taken directly from source):



? Diabetes prevalence in England increased from 3.6% in 2005/6 to 4.3% in 2009/10.



? ?Drugs for diabetes' is the BNF section of highest cost and greatest increase in cost in primary care in England over the last year.



? In 2010/11 there were 38.3 million items prescribed for diabetes at a net ingredient cost of ?725.1 million.



? Prescribing for diabetes accounted for 4.1% of items and 8.4% of the total cost of prescribing in 2010/11 compared with 3.7% and 6.6% in 2005/6.



? Use of oral antidiabetic metformin rose from 8.6 million items in 2005/6 to 14.6 million items in 2010/11. This follows NICE's recommendation that this drug should be first choice for oral therapy.

 

[everydayupsanddowns]

I wonder what the cost savings(?) would be if rather than Metformin being the default initial treatment (as it seems to be) they prescribed test strips for the first 6 months and a copy of Jennifer's Advice/Maggie Davey's letter. So many forum types seem to be able to reduce/ do away with oral meds after discovering low/moderate carb that it makes me wonder what would happen if everyone were given slightly different dietary advice from the start, not just the sorts of people who seek out forums.

 

[Copepod]

Metformin is a very cheap drug - "Metformin (Non-proprietary)
Tablets, coated, metformin hydrochloride 500 mg, net price 28-tab pack = ?1.07, 84-tab pack = ?1.57; 850 mg, 56-tab pack = ?1.67." according to BNF. So, 6 months of 500mg metformin would cost less than ?7, whereas even one pack of 50 blood glucose tests strips would cost around three times that amount. I can see why NICE is so keen to promote this drug rather than any others in the first line.
However, I agree that appropriate advice regarding carbohydrate contents of foods could be very effective in managing type 2 diabetes and should be provided to all newly diagnosed.

 

[Northerner]

Metformin is a very cheap drug - "Metformin (Non-proprietary)
Tablets, coated, metformin hydrochloride 500 mg, net price 28-tab pack = ?1.07, 84-tab pack = ?1.57; 850 mg, 56-tab pack = ?1.67." according to BNF. So, 6 months of 500mg metformin would cost less than ?7, whereas even one pack of 50 blood glucose tests strips would cost around three times that amount. I can see why NICE is so keen to promote this drug rather than any others in the first line.
However, I agree that appropriate advice regarding carbohydrate contents of foods could be very effective in managing type 2 diabetes and should be provided to all newly diagnosed.

Yes, it would be interesting to see how the cost of metformin compares to the cost of test strips i.e. what proportion of the total cost to NHS was strips. I think another problem with giving strips instead of metformin would be the cost of time spent educating and supporting people during a period of testing. I suspect there aren't even sufficient resources to achieve that. Certainly though, better dietary advice from the outset would be as cheap to provide as the current, less appropriate advice!

 

[everydayupsanddowns]

I wonder if the drug-focussed approach might lead some to underestimate the potential effect of dietary changes. Rather than, 'Make these changes to diet and lifestyle and with the support of this tablet your body should be able to cope' it feels as if many are told, 'take these pills and stop taking sugar in your tea, well most of the time anyway... if that doesn't work we'll give you some more pills...'

I may have this completely wrong, of course.

 

[Barb3234]

My Gp wanted to prescribe tablets immediately - at an FBG of 7.2 I didn't think it was reasonable and wanted to give D&E a go. I think Dr's are far too keen to get the prescription pad out. My doctor's attitude was that I would be 'unlikely' to stick to the D&E so might as well go straight onto tablets. Hmm, thanks for that I thought. 25lbs lighter, bgs coming down into normal range 95% of the time, I think that kind of makes the point!

 

[everydayupsanddowns]

...My doctor's attitude was that I would be 'unlikely' to stick to the D&E so might as well go straight onto tablets. Hmm, thanks for that I thought. 25lbs lighter, bgs coming down into normal range 95% of the time, I think that kind of makes the point!

Sadly I think that might be many GPs position Barb.

Well done for sticking to your guns and proving yours wrong!