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Rising cost of drugs for diabetes approaches £1 billion per year

The net ingredient cost (NIC)(2) of drugs for diabetes has increased by £88.0 million in 2015/16, bringing the annual primary care prescribing spend on this drug classification to £956.7 million - around £2.6 million per day, figures published today show.

*NHS Digital must be quoted as the source of these figures

*Regional data are available within this report

NHS Digital's report Prescribing for Diabetes 2005/06 to 2015/16 also shows that in the last financial year, 49.7 million prescription items3 were dispensed in England for the treatment and management of diabetes.

The £956.7 million spend makes up 10.6 per cent of the total cost of all prescribing in primary care in England, and is almost double the cost of a decade ago, when it was £513.9 million, or 6.6 per cent of the overall spend.

Since 2007/08, the British National Formulary classification Drugs used in diabetes4 has accounted for the highest cost of all drug sections, while the number of prescription items dispensed in this category has also increased every year since 2005/06. This is in line with a steady increase year on year in the percentage of the population being treated for diabetes.

On a national level, the Quality and Outcomes Framework5 report of 2014/15 shows that the average percentage of all GP-registered patients, aged 17 and over, in England, being treated for diabetes has increased from 5.3 per cent in 2009/10 to 6.4 per cent in 2014/15. This means in 2014/15 there were 2.9 million adults in England receiving treatment for diabetes.

Further analysis for the 2015/16 financial year in Prescribing for Diabetes shows:  

  • 17.9 per cent of Newham CCG's total prescribing spend was on drugs used in diabetes maintenance - the highest percentage of all CCGs in England. Newham also had the highest percentage in England for diabetes drug items dispensed, at 9.0 per cent of its overall number of drug items dispensed.
  • 7.4 per cent of North Tyneside CCG's total prescribing spend was on drugs used in diabetes - the lowest percentage of all CCGs in England. North Tyneside also had the lowest percentage in England for diabetes drug items dispensed, at 3.6 per cent of its overall number of drug items dispensed.
  • The NIC per person in 2015/16, on the QOF diabetes register of 2014/15, ranged from £415.3 (NHS Warwickshire North) at the highest, to £238.7 (NHS Northumberland CCG) at the lowest.
  • Of the three main diabetes treatment areas in primary care for 2015/16, prescribed antidiabetic drugs6 cost the NHS £422.7 million, prescribed insulin7 cost the NHS £343.7 million, and prescribed diagnostic and monitoring devices8 cost the NHS £186.6 million.

Read the full report at: http://digital.nhs.uk/pubs/presdiab0516

ENDS


Notes to editors

1. NHS Digital is the national information and technology provider for the health and care system. Our team of information analysis, technology and project management experts create, deliver and manage the crucial digital systems, services, products and standards upon which health and care professionals depend. Our vision is to harness the power of information and technology to make health and care better. NHS Digital is the new trading name for the Health and Social Care Information Centre (HSCIC). We provide 'Information and Technology for better health and care'. Find out more about our role and remit at www.digital.nhs.uk

2. Net Ingredient Cost: The basic cost of a drug to the NHS. NIC does not take account of discounts, dispensing costs, fees, or the income from prescription charges.

3. Prescription item: Prescribers in the community write prescriptions on a prescription form, known as an FP10. Each single item written on the form is, in this report, counted and considered as a prescription item.

4. BNF chapter 6.1 Drugs used in diabetes: The prescribing analysis and cost tabulation (PACT) system uses the therapeutic classifications defined in the British National Formulary (BNF) using the classification system prior to edition 70. Information on why a drug is prescribed is not available in this dataset. Since drugs can be prescribed to treat more than one condition, it may not be possible to separate the different conditions for which a drug may have been prescribed. The primary purpose of the BNF is to provide information for clinicians. The format of the BNF was changed with Edition 70 (September 2015 - March 2016) to make it more user-friendly. However, the NHS Business Service Authority, who process dispensed prescription forms and collects dispensed prescribing data and produce the PACT data, continue to use the old BNF classification system to code medicines, which has become widely used in the UK as a classification to allow comparisons between drug groups. For example it is used to report cost and trend in medicines use and supports several NHS Digital official publications. The data are also used in many NHS IT systems. Chapter 6.1 of the BNF includes insulins, oral antidiabetic drugs, and monitoring devices. This does not include hypodermic equipment, which is recorded in the BNF section "Other appliances".

5. The Quality and Outcomes Framework (QOF) is designed to improve the quality of care patients are given, by rewarding GP practices for the quality of care they provide to their patients.

6. Antidiabetic drugs (BNF 6.1.2) are taken orally and are generally used for treatment of type 2 diabetes. They should generally only be prescribed if a patient does not respond adequately to at least three months' restriction of energy and carbohydrate intake and an increase in physical exercise.

7. Insulin (BNF 6.1.1) plays a key role in the regulation of carbohydrate, fat, and protein metabolism and is given by injection. Hypodermic equipment (BNF 6.1.1.3) is excluded from the analysis.

8. Diagnostic and monitoring devices (BNF 6.1.6) includes glucose blood testing kits, ketone blood testing reagents, and urine testing reagents.

9. Figures over 1 million have been rounded to the nearest 100,000. Other figures (including percentages) have been rounded to one decimal place.

10. For media enquiries, please contact the press office on 0300 303 3888 or media@nhsdigital.nhs.net

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