Open AccessThe pattern of prescribing of glucose modulating agents for type 2 diabetes in general practices in England 2016/17
Author(s) -
Heald Adrian H.,
Livingston Mark,
Bien Zuzanna,
Moreno Gabriela Y.C.,
Laing Ian,
Stedman Mike
Publication year - 2018
Publication title -
international journal of clinical practice
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.756
H-Index - 98
eISSN - 1742-1241
pISSN - 1368-5031
DOI - 10.1111/ijcp.13080
Subject(s) - medicine , liraglutide , medical prescription , type 2 diabetes , formulary , gliclazide , exenatide , glimepiride , diabetes mellitus , pharmacoepidemiology , pediatrics , family medicine , emergency medicine , pharmacology , endocrinology
Summary Background In the financial year 2016/17 there were 52.0 million items prescribed for diabetes at a total net ingredient cost of £983.7 million ‐ up from 28.9 million prescription items and £572.4 million in 2006/07. Anti‐diabetes drugs (British National Formulary section 6.1.2) make up 45.1 per cent of the total £983.7 million net ingredient cost of drugs used in diabetes and account for 72.0 per cent of prescription items for all diabetes prescribing. Methods We examined the way that agents licensed to treat type 2 diabetes were used across GP practices in England in the year 2016/2017. Analysis was at a GP practice level not at the level of patient data. Results Annual prescribing costs / patient / medication type for monotherapy varied considerable from £11/year for gliclazide and glimepiride to £885/year for Liraglutide. The use of SGLT‐2i agents grew strongly at 70% per annum to around 100,000 DDD with prescriptions seen in 95% of GP practices. Liraglutide expenditure (11% of total) was high for a relatively small number of patients (1.3% of Defined Daily Doses), with still significant spend on exenatide. Liraglutide use significantly exceeded that of other glucagon‐like peptide‐1 (GLP‐1) agonists. Conclusions Our work demonstrates the significant cost of medication to modulate tissue glucose levels in type 2 diabetes and the dominance of some non‐generic preparations in terms of number of prescriptions and overall spend. There are some older sulphonylureas in use, which should not generally be prescribed. Regular audit of patient treatment at a general practice level will ensure appropriate targeted use of licensed medications and of their cost effectiveness.