Diabetes prescriptions outstrip increase in overall prescribing

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A report from NHS Digital has revealed that prescriptions for diabetes treatment in primary care have increased by more than 80% over the last decade.

To put this in perspective, there has been a 46% rise during the same period across all primary care prescribing.

The report, Prescribing for Diabetes: England 2006/07 to 2016/17, shows that in the last year the number of items prescribed for diabetes grew more than twice as fast (4.7%) as the overall prescriptions across primary care (2.0%).

52.0 million items were prescribed for diabetes in 2016/17 – up from 49.7 million in 2015/16, and 28.9 million in 2006/07.

For the years where comparable figures are available, prescribing for diabetes in primary care has grown nearly twice as quickly as the rise in diabetes prevalence across the population.

The latest prevalence figures available, from the Quality Outcomes Framework, show that there was a 22.6% increase in diabetes prevalence in England between 2009/10 and 2015/16.

Prescriptions in primary care for diabetes increased by 40% over the same period and prescriptions for the most commonly prescribed category of diabetes drugs, Biguanides (metformin), rose by 51.5% over this period.

Looking across the whole of the last decade, prescribing of metformin for diabetes has more than doubled, from 9.4 million items in 2006/07 to 20.8 million items in 2016/17.

Cost or Net Ingredient Cost (NIC) is the basic cost of a drug. It does not take account of discounts, dispensing costs, fees or income from prescription charges, so the amount the NHS spent will be slightly different.

In 2016/17 prescription items for diabetes accounted for around £1 in every £9 of the cost of prescription items across primary care. In 2006/07 it was less than £1 in every £14.

The cost of diabetes drugs increased over the last year, compared to the cost of prescriptions across primary care falling overall.

Drugs Used in Diabetes accounts for the highest cost of all British National Formulary (BNF) therapeutic areas by BNF section. This has been the case since 2007/08.

Between 2015/16 and 2016/17, there was a marginal reduction in the overall cost of prescription items across primary care, with the figure falling below £9 billion. But, over this period, there was a £27 million increase for diabetes which totalled £983.7 million in 2016/17.

Prescribing for diabetes also shows drugs classified as “other antidiabetic drugs” – often new products to the market – are the most expensive category of drugs used in diabetes, for the first time overtaking the cost of human analogue insulin.

They account for a low proportion of all items prescribed for diabetes, but that figure is rising. In 2016/17 they cost £322.5 million, compared with £103 million in 2006/07.