Costs of diabetes drugs spiral
With current NHS spending under review, researchers say the NHS is now spending too much on diabetes drugs and accounts for 7% of the UK prescribing budget.
Researchers from Cardiff University say, “despite a big rise in the number of people being diagnosed with type 2 diabetes in recent years, does not fully explain the spiralling costs.”
As people’s lifestyle continues to change, the rate of increase of type 2 diabetes is set to continue and the NHS needs to get the budget under control, they conclude. But in answer to these claims, GPs said, “They had to look out for the best interests of their patients.”
In 2008 the NHS spent £700m on drugs to control blood sugar levels of diabetes patients. Between 2000 and 2008 the number of prescriptions for glucose-lowering drugs had risen by 50% the researchers calculated.
Writing in the journal Diabetic Medicine, they said, “Figures for England specifically show an increase from £290m to £591m over the study period. Even taking into account the price of inflation, this is a rise of 104%. There has been over this time period a marked increase in the use of expensive therapies. Newer drugs like rosiglitazone as well as increasing use of insulin have contributed to the increased costs.”
Dr Chris Currie said, “The findings suggest that national guideline are not being followed. The National Institute for Health and Clinical Excellence recommends lifestyle changes as a first step in controlling type 2 diabetes, before drug treatment is started. GPs should then start people on the basic treatments before looking at other options if they do not work.”
Despite rising costs due to new expensive treatments being marketed by drugs companies, the figures also showed cheaper generic drugs such as metformin being prescribed as first line treatments.
With an estimated 2.6 million people in the UK having diabetes, of which 90% having type 2 and a further estimate of over 1 million not yet diagnosed, “the drugs bill is extremely high,” said Dr Currie. “Somebody has got to take a lead in managing the way we treat people with diabetes and making sure doctors adhere to the recommendations. This is going to continue to rise and part of the issue is people don’t realise how big the problem is.”
But Dr Niti Pall, a Birmingham based GP and spokesperson for Diabetes UK said, “She did not agree with the author’s conclusions. The job of GPs was to get blood sugar levels as low as possible by whatever means possible to prevent complications in their patients. They have not looked at the health economics; we are saving the NHS money in the long run. We need to do whatever it takes to get blood sugar down and some of the cheaper drugs don’t do the job.”
With continuing demand on the NHS to reduce costs, it is GPs and GP locums who are best placed to make these decisions for their patients.
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