NHS: Diabetes rise leads to overall healthcare cost increase in U.K.

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An upsurge in the number of people in the U.K. diagnosed with diabetes has been linked to a 40 percent rise in costs over the last four years. According to the latest NHS report published July 30, the number of diabetes-related prescriptions distributed has reached 35.5 million and soaked up £650 million ($953 million U.S.) in costs.

In 2004-2005, the number of patients listed in the Quality and Outcomes Framework (QCF) register was 1.77 million—a 3.3 percent prevalence. In 2009-2010, the number of diabetics rose to 2.21 million—a 4.1 percent prevalence within the population.

According to the report, in 2009-10, 5.7 million insulin items were prescribed which contributed to a net ingredient cost of £299.2 million ($389.8 million U.S.)—a 3.4 percent increase in items and 3.8 percent increase in costs from 2008-2009. Between 2004 and 2010, these numbers increased by 43.1 percent and 41.6 percent, respectively.

The report showed that the number of antidiabetic drugs prescribed to patients in 2009-10 was 23.4 million and the costs associated with these drugs reached £198.5 million ($259.4 million U.S.).

The report also found that metformin use, the first-line drug therapy recommended by the National Institute for Health and Clinical Excellence (NICE), increased by 73.3 percent—from 7.6 million items in 2004-2005 to 13.2 million in 2009-2010. The costs associated with these increased prescriptions rose from £23.2 million ($30.3 million U.S.) to £60.5 million ($79.1 million U.S.).

Likewise, during this period, the number of sulphonylurea prescriptions rose from 5.4 million to 7.1 million—a 31.5 percent increase.

In the case of thiazolidinediones, pioglitazone (Actos, Takeda) and rosiglitazone (Avendia, GlaxoSmithKline), the rates of use rose by 89.5 percent, from 1.2 million in 2004 to 2.3 million in 2010. Additionally, the costs associated with these prescriptions rose from £56.9 million ($74.4 million U.S.) to £78.6 million ($102.7 million U.S.).

However, the use of rosiglitazone decreased significantly from 2007-2008 to 2009-2010 and may due to the increased box warnings the FDA slapped on rosiglitazone after finding that the drug could have the potential to raise risk of cardiovascular events in heart failure patients.

“The MHRA safety warnings may have also contributed to the increases in the prescribing of other antidiabetic drugs, in particular exenatide (£5.6 million --$7.3 million U.S.-- NIC in 2008-2009 rising to £13.5 million—$17.6 million U.S.—in 2009-2010) and sitagliptin (£5.1 million [$8 million U.S.] NIC in 2008/09 rising to £14.2 million [$22.3 million U.S.] in 2009/2010),” noted NHS.

Lastly, NHS found that use of glucose monitoring devices and agents increased by 9.9 percent from 2004-10 and exhibited an 11.4 percent increase in costs. This technology accounted for 16.5 percent of the total diabetes treatment items and 22.5 percent of the costs.

The reports prescription data was taken from the NHS Prescription Services database.