Forty per cent rise in cost and number of drug items prescribed to treat diabetes in England

Just over 35.5 million prescription items were dispensed to treat diabetes in 2009/10 at a net ingredient cost of nearly £650 million – a rise of more than 40 per cent over five years - a new report from The NHS Information Centre has shown.

The figures refer to prescribing in primary care in England and represent a 43 per cent increase in items and a 42 per cent increase in net ingredient cost compared to 2004/05, when 24.8 million items were dispensed at a net ingredient cost of £458.6 million.

The report; Prescribing for Diabetes in England: 2004/5 to 2009/10, also shows that between 2004/5 and 2009/10:

• The cost of prescribing for diabetes represented 7.7 per cent of the total cost of prescribing in primary care in 2009/10, compared to 5.8 per cent in 2004/5,

• There was a 73 per cent increase in items prescribed of the drug metformin; from 7.6 million items in 2004/5 to 13.2 million items in 2009/10. Over the same period the total net ingredient cost rose by 161 per cent from £23.2 million to £60.5 million. Metformin is recommended by the National Institute for Health and Clinical Excellence (NICE) as the first choice drug for oral therapy.

• There was a 90 per cent increase in items prescribed of thiazolidinediones drugs (pioglitazone and rosiglitazone, which can also be used in combinations with metformin) from 1.2 million in 2004/05 to 2.3 million in 2009/10. Over the same period the total net ingredient cost rose by 38 per cent from £56.9 million to £78.6 million.

• There was a 116 per cent increase in items prescribed of human analogue insulins; from 2.1 million items in 2004/5 to 4.5 million items in 2009/10. Over the same period the total net ingredient cost rose by 132 per cent from £109.8 million to £255.2 million.

• There was a 10 per cent increase in the items prescribed of diagnostic and monitoring agents, used for patient self testing of glucose levels in blood; from 5.3 million items in 2004/5 to 5.9 million items in 2009/10. Over the same period the total net ingredient cost rose by 11 per cent from £130.9 million to £145.8 million.

• The prevalence of diabetes in England increased; from 3.3 per cent in 2004/05 to 4.1 per cent in 2008/9. Prevalence differed by Primary Care Trust (PCT), ranging from 2.5 per cent to 5.7 per cent in 2008/9.

NHS Information Centre chief executive Tim Straughan said: “This report provides an insight into both national and local prescribing patterns for what is an increasingly prevalent condition in England. It shows that both the total prescription items being dispensed to treat diabetes have increased markedly and the total net ingredient cost to the NHS of those items has increased by almost £200 million since 2004/5.

“The relatively high cost of some of the newer drugs used to treat diabetes is partly why the net ingredient cost bill has increased by 42 per cent in five years while overall prescribing costs have only risen by 6 per cent rise during the same time period.”