The cost and number of drugs prescribed under the NHS to treat diabetes in England has rocketed more than 40% in just five years, now representing 7.7% of the total cost of prescribing in primary care.

Just over 35.5 million prescription items were dispensed to treat diabetes in 2009/10 at a net ingredient cost of nearly £650 million, representing respective increases of 43% and 42% from 2004/5 (when detailed prevalence figures on the disease first became available as part of GPs’ Quality and Outcomes Framework), a report by the NHS Information Centre has found.

What these figures show is the headline cost of medicines before discounts or charges paid are deducted, and therefore do not represent the actual cost to the NHS, but despite this many of the overall messages similar, the Centre said.

Looking at the finer details, the report discovered a 73% increase in the number of scripts for metformin – the National Institute for Health and Clinical Excellence’s first choice oral drug for use on the NHS – over the five years, coupled with a 161% leap in total net ingredient cost to £60.5 million.

A 90% increase was seen for prescriptions of the thiazolidinedione drugs pioglitazone and rosiglitazone, which can also be used in combination with metformin, to 2.3 million, with a 38% rise in ingredient cost to £78.6 million over the five-year period. Similarly, human analogue insulin prescriptions rocketed 116% to 4.5 million items in 2009/10, and the net ingredient cost shot up 132% to £255.2 million.

According to NHS Information Centre chief executive Tim Straughan, the report clearly shows that 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% in five years while overall prescribing costs have only risen by 6% rise during the same time period,” he explained.

“This large rise in diabetes drug prescriptions and costs appears to be equally due to the far greater population of people with diabetes and to the wider prescribing of newer and more expensive therapies,” noted Simon O’Neill, Director of Care, Information and Advocacy at Diabetes UK.

But he also stressed that “the long-term costs of poor diabetes management i.e. care for someone who’s had a heart attack or stroke, lost their sight or lower limb, far outweigh those of the drugs that help prevent such devastating complications”.

Mixtard decision costly for NHS

Meanwhile, according to an editorial in the Drug and Therapeutics Bulletin, the NHS’ diabetes bill could be substantially increased by Novo Nordisk’s decision to stop selling its Mixtard 30 insulin drug in the UK.

As PharmaTimes UK News reported in June, the company plans to discontinue sales of the product at the end of the year following a steady decline in the products use in the UK and Ireland over the last six years.

However, the move could cost the NHS an extra £9 million in England alone, as thousands of patients will be forced to find alternative - and potentially more expensive – forms of insulin to manage their disease.

“This is quite apart from the extra resources needed to review patients, to discuss and decide on alternative treatments, and the disruption and concern such changes may cause for affected individuals,” says the DTB, which has launched a campaign Don’t Drop Mixtard to persuade Novo Nordisk to keep the drug on the market.