Prescribing for Diabetes – England 2015/16 to 2020/21

NHSBSA | August 2021 | Prescribing for Diabetes – England 2015/16 to 2020/21

 This publication from the NHS Business Services Authority aims to describe the prescribing of medicines and appliances used for the treatment of diabetes in a primary care setting in England that are dispensed in the community

Key findings:

  • in 2020/21, there were 57.9 million drugs used in treating diabetes prescribed in England for a cost of £1.19 billion, 12.5% of the total spend on all prescription items prescribed in England. This was an increase from 2015/16 where 49.7 million diabetes items were prescribed in England for a cost of £958 million, representing 10.4% of the total spend on all prescriptions items.
  • antidiabetic drugs were the most prescribed drugs used in treating diabetes in England in 2020/21 with 43.1 million items at a cost of £686 million. The costs of antidiabetic drugs have increased by 62% since 2015/16 from £423 million.
  • there were 3.05 million identified patients that were prescribed drugs used in diabetes in England in 2020/21. This was a 1.5% increase from 3 million identified patients in 2015/16, and a 12.7% increase from 2.70 million in 2015/16.
  • the median age of identified patients for drugs used in diabetes was 64 in 2020/21, this has remained consistent since 2015/16. The most common age group in 2020/21 was 70 to 74, this has increased from 2015/16 where the most common age group was 65 to 69.
  • areas of greater deprivation have the highest number of identified patients being prescribed drugs used in treating diabetes in 2020/21, with the number of patients receiving prescribing in the most deprived areas of England being 264% of the least deprived areas

Prescribing for Diabetes – England 2015/16 to 2019/20

NHS Business Service Authority | November 2020 | Prescribing for Diabetes – England 2015/16 to 2019/20

NHS Business Service Authority has released its latest statistician release which includes data for prescribing for diabetes; it to describe the prescribing of medicines and appliances used for the treatment of diabetes in a primary care setting in England that are dispensed in the community.

Key findings
  • The number of prescription items used primarily in the treatment of diabetes has increased every year between 2015/16 and 2019/20.
  • The number of patients has also increased every year between 2015/16 and 2019/20 but has not increased as much as items. This has resulted in a greater number of items per patient in 2019/20 than in previous years.
  • The total cost of diabetes drugs prescribed has increased since 2015/16, driven by large increases in costs of antidiabetic drugs and insulin. These increases are larger than both the number of items prescribed and the number of patients. This has resulted in increased cost per person in 2019/20 than in previous years.
  • Antidiabetic drugs remain the most prescribed of the diabetes items. Prescribing for all categories increased between 2018/19 and 2019/20, except for diabetic diagnostic and monitoring agents, which decreased by 6%.
  • Overall demographics of patients have remained steady over the last five years. The median age has remained constant at 64 and the split by sex has remained 55% male and 45% female patients since 2015/16.
  • Areas of greatest deprivation have the highest number of patients per population receiving diabetes medicines, with 8.6% of people in the most deprived areas receiving diabetes medication, compared to 3.4% of people in the least deprived areas. This pattern is replicated at drug levels, with 7.5% of the population in the most deprived areas receiving antidiabetic drugs, compared to 2.9% of people in the least deprived areas.

Prescribing for Diabetes – England 2015/16 to 2019/20

Up to a third of people with type 2 diabetes not taking prescriptions properly

University of Leicester | April 2019 | Up to a third of people with type 2 diabetes not taking prescriptions properly

A new study from researchers at the University of Leicester used a special screening approach to analyse urine samples from 228 patients with diabetes taken at their annual diabetes review. The urine samples were screened for 60 different medicines used to treat type 2 diabetes, heart conditions and high blood pressure (hypertension). The experts found that more than a quarter (28.1 per cent) (n=64); had taken none or not all of their prescribed medication. 

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Their findings suggest that nearly a third of people with type 2 diabetes may be putting their health at risk because they are not taking their medications correctly.

Dr Prashanth Patel, a consultant and co-director of NCAT at Leicester’s Hospitals, and study co-author, said: “These findings had a knock-on effect, as those who had not been taking their prescription drugs regularly had significantly higher blood sugar levels compared with those who had been.

“We also found they were more prone to higher levels of microalbumin, a marker that the kidneys may not be healthy, as well as higher blood pressure and more fat levels in the blood, otherwise known as the lipid profile.”

Failing to take prescription drugs properly is called non-adherence. This is problematic because, if not managed correctly, type 2 diabetes can lead to further health complaints, such as kidney disease, limb amputation and cardiovascular problems (Source: University of Leicester).

University of Leicester [press release]  Up to a third of people with type 2 diabetes not taking prescriptions properly

The study has been published in Diabetes Care 

Full reference: Patel, P., Gupta, P., Burns, A., Mohamed, A. A., Cole, R., Lane, D., … & Khunti, K. (2019). Biochemical Urine Testing of Adherence to Cardiovascular Medications Reveals High Rates of Nonadherence in People Attending Their Annual Review for Type 2 Diabetes. Diabetes care.

Abstract

OBJECTIVE Liquid chromatography—tandem mass spectrometry (LC-MS/MS) is a new method to objectively and robustly detect nonadherence. We applied this technique to study nonadherence to cardiovascular medications in people with type 2 diabetes (T2DM).

RESEARCH DESIGN AND METHODS Routine urine samples, received at the time of the annual diabetes review from 228 people with T2DM in primary care, were assessed for adherence by LC-MS/MS.

RESULTS A total of 28.1% patients (N = 64) were nonadherent to antidiabetic, antihypertensive, and/or lipid-lowering medications. Nonadherence to statins was the highest at 23.7%, and nonadherence to oral hypoglycemic agents was 9.3%. HbA1c, albumin-to-creatinine ratio, and lipid profiles were significantly higher in the patients who were nonadherent compared with those who were adherent to treatment.

CONCLUSIONS This unique study shows that routine urine samples can be used for adherence testing screening by LC-MS/MS and has demonstrated high nonadherence rates especially to statins in people with T2DM. Future intervention studies using LC-MS/MS as a diagnostic/therapeutic tool may help to improve clinical outcomes.

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