Which is cheaper libre or test strips?

[Amity Island]

Hi Everyone,

Following on from my previous post, i'm trying to establish which is actually cheaper (purely on cost, not all the other benefits that libre gives) on a "like for like" basis.

So, based on my average number of libre scans (tests) per day of 16.

Freestyle Libre Sensors at around £35 (at nhs cost) for 14 days is 14days x 16pain free scans per day = 224 scans(tests) for £35 = 15p per scan (test)

OR

Blood glucose test strips at £10 (at NHS cost) for 50. = 20p per test.

Making blood test strips more expensive, without all the extra benefits that the libre gives.

Can anyone else add anything to this?

 

[Robin]

I think one of the criteria for prescribing the Libre, is if you need to test 8 or more times a day, on the grounds that it becomes cost neutral at that point.

The thing I find, though, is that although I average 16 swipes a day when I've got a sensor on, when I'm back on test strips, there’s no way I'd do 16 because some of the swipes are when I'm in the middle of gardening, or riding, or a walk or something inconvenient for finger pricking, and also, I just don’t want to make that many holes in my fingers, so I make do with fewer. Therefore any doctor would argue that strips are cheaper because I obviously don’t need to do 16! My argument would be, though, that I have much better control in terms of spikes and dips, peace of mind, etc, when I'm able to test 16 times, even though I don’t see much improvement in HbA1c, and I think this ought to be the criteria for prescribing.

(I’m currently trying to get referred back to the hospital, so I can put in a bid for getting the Libre prescribed, but it’s taking ages)

 

[Bruce Stephens]

I scan (on average) over 30 times a day, apparently. (35 per day over the last 90 days.) I also scan now and again with the Reader (13 times a day over 90 days, it says).

That's not especially convincing if you're looking at the immediate costs, though. In terms of that you want to know how many test strips I might otherwise use, which I'm sure is way less than 40 a day.

It feels more useful to say that I was never testing enough, and with the Libre I am (because it's so easy), and I'm now vastly less likely to require paramedic help recovering from a hypo. And (one hopes) less likely to suffer from complications (or maybe those complications will be less severe). And my quality of life is much improved, which jolly well ought to count for something.

 

[Amity Island]

I think one of the criteria for prescribing the Libre, is if you need to test 8 or more times a day, on the grounds that it becomes cost neutral at that point.

The thing I find, though, is that although I average 16 swipes a day when I've got a sensor on, when I'm back on test strips, there’s no way I'd do 16 because some of the swipes are when I'm in the middle of gardening, or riding, or a walk or something inconvenient for finger pricking, and also, I just don’t want to make that many holes in my fingers, so I make do with fewer. Therefore any doctor would argue that strips are cheaper because I obviously don’t need to do 16! My argument would be, though, that I have much better control in terms of spikes and dips, peace of mind, etc, when I'm able to test 16 times, even though I don’t see much improvement in HbA1c, and I think this ought to be the criteria for prescribing.

(I’m currently trying to get referred back to the hospital, so I can put in a bid for getting the Libre prescribed, but it’s taking ages)

Robin,
I thought it was standard practice for type 1's to be monitored through a diabetes team at a hospital and not by their GP? You are more likely to get the libre put onto your regular g.p prescription via the hospital?

 

[Amity Island]

I think one of the criteria for prescribing the Libre, is if you need to test 8 or more times a day, on the grounds that it becomes cost neutral at that point.

The thing I find, though, is that although I average 16 swipes a day when I've got a sensor on, when I'm back on test strips, there’s no way I'd do 16 because some of the swipes are when I'm in the middle of gardening, or riding, or a walk or something inconvenient for finger pricking, and also, I just don’t want to make that many holes in my fingers, so I make do with fewer. Therefore any doctor would argue that strips are cheaper because I obviously don’t need to do 16! My argument would be, though, that I have much better control in terms of spikes and dips, peace of mind, etc, when I'm able to test 16 times, even though I don’t see much improvement in HbA1c, and I think this ought to be the criteria for prescribing.

(I’m currently trying to get referred back to the hospital, so I can put in a bid for getting the Libre prescribed, but it’s taking ages)

Robin,
I think that this is very telling, if diabetics are scanning 16 times a day, whether it's because of the convenience or not, it must be necessary? Otherwise why would you do it? It makes one think about how many tests diabetics don't do each day because of the pain/inconvenience of finger pricking.

 

[Amity Island]

I scan (on average) over 30 times a day, apparently. (35 per day over the last 90 days.) I also scan now and again with the Reader (13 times a day over 90 days, it says).

That's not especially convincing if you're looking at the immediate costs, though. In terms of that you want to know how many test strips I might otherwise use, which I'm sure is way less than 40 a day.

It feels more useful to say that I was never testing enough, and with the Libre I am (because it's so easy), and I'm now vastly less likely to require paramedic help recovering from a hypo. And (one hopes) less likely to suffer from complications (or maybe those complications will be less severe). And my quality of life is much improved, which jolly well ought to count for something.

Bruce,
At 35 tests/scans a day you're certainly getting your money's worth and plenty of value out of the libre 🙂

 

[mikeyB]

I average 15 scans per day. Just because I can, though I never tested that much pre-Libre. I’ve not developed any diabetes complications in 24 years of T1, so it’s hard to prove any benefit. Except, perhaps, for a reduction in HbA1c. But what does that show about HbA1c and the risk of development of complications before I used the Libre? These are such individual risks that it’s hard to generalise.

I’ve got an appointment on March 10 with the diabetes consultant, theoretically about the possibility of a pump. I have serious doubts about jumping over that particular hoop. I’m not going to bother to ask about getting sensors prescribed, I can easily cover the cost.

 

[Robin]

Robin,
I thought it was standard practice for type 1's to be monitored through a diabetes team at a hospital and not by their GP? You are more likely to get the libre put onto your regular g.p prescription via the hospital?

I was discharged back to my GP surgery a few years ago, when the hospital was trying to get rid of a few of their more stable patients to make room for new ones! My surgery nurse doesn’t know much about Type 1, but she is supposed to be able to refer me, or to ask advice from, a specialist DSN at any time. In fact, I haven’t felt I've needed this, until now, when it’s the only way to get the libre prescribed. I also felt it probably would be beneficial to have a chat with a specialist department in case there’s something I'm missing, or some input they can give, so I've asked to be referred back.

 

[Bruce Stephens]

But what does that show about HbA1c and the risk of development of complications before I used the Libre? These are such individual risks that it’s hard to generalise.

Agreed. I'm much more confident about my quality of life improvements. After starting using the Libre it became obvious I'd been going hypo most nights (maybe every night). Now that I don't, I feel much less tired during the day. And using Libre ended a year when several times I had hypos requiring an ambulance (or paramedic on a bike). Now it's usually straightforward to avoid hypos.

 

[Amity Island]

These are such individual risks that it’s hard to generalise.

Mike,
Quite a profound statement that. I agree totally, it seems that way for health generally, some people seem to avoid any health problems when they live a less than healthy life and then there's those that lead a very healthy lifestyle and suffer. It seems very individual.

 

[Amity Island]

I was discharged back to my GP surgery a few years ago, when the hospital was trying to get rid of a few of their more stable patients to make room for new ones! My surgery nurse doesn’t know much about Type 1, but she is supposed to be able to refer me, or to ask advice from, a specialist DSN at any time. In fact, I haven’t felt I've needed this, until now, when it’s the only way to get the libre prescribed. I also felt it probably would be beneficial to have a chat with a specialist department in case there’s something I'm missing, or some input they can give, so I've asked to be referred back.

Robin,
Snap. Same happened to me, I've been through G.P for most of my diabetic life, but then went back into hospital appointments to make my case for getting the libre on prescription.

 

[Bruce Stephens]

I thought it was standard practice for type 1's to be monitored through a diabetes team at a hospital and not by their GP?

Varies. Where I am it seems normal to be under your GP but with easy availability of the local hospital team (so I've had a few appointments with them, but they discharged me after about a year). I imagine newly diagnosed patients start with the hospital team. (I've been diabetic for decades now, and ended up seeing the DSNs because I was having such nasty hypos.)

I got Libre on prescription (at least for the six months; they're slightly overdue for the review of that) via my GP surgery but the hospital team is actually organising it.

 

[Bruce Stephens]

I think that this is very telling, if diabetics are scanning 16 times a day, whether it's because of the convenience or not, it must be necessary? Otherwise why would you do it? It makes one think about how many tests diabetics don't do each day because of the pain/inconvenience of finger pricking.

I think calling my (roughly) 50 a day scanning as something I "need". These things are all some combination of habit, cost, benefit. Scanning with a Libre is (for me) really, really, cheap: I work with my phone and Reader on my desk, so scanning is extremely easy and costs nobody anything. (The sounds are turned off in both cases, too.) And when I'm walking around I usually have both in my pocket.

One of the videos on Libre suggests not scanning too often; most of the time it's not at a time when you ought to be reacting to a reading. I can see the argument, but most of the time I'm scanning and seeing that things are about what I expected so I don't need to do anything. So it's reassurance rather than anything else. (The downside is those occasions where I'm without a sensor, but last time I was OK again with test strips after a couple of days.)

(It seems I was wrong about the cost of FreeStyle Optium test strips. At least, Amazon (or a few of their sellers) are selling strips for more like £12 for 50, so presumably they're under £10 for the NHS. Looks like they fell (on Amazon) quite sharply during 2018.)

 

[Amity Island]

[QUOTE="So it's reassurance rather than anything else.[/QUOTE]
Hi Bruce,
That was my original point, it takes away that question "are my levels ok?". It's reassurance, which is very, very important when you are living with a condition like insulin dependent diabetes.