September Group meeting - Diabetes Prescription Costs etc in Mid Essex

Paula Wilkinson, who is the Chief Pharmacist at the Mid-Essex Clinical Commissioning Group, gave an interesting and informative presentation to around 20 members.

The total prescription budget in Mid Essex is set at around £55m. The Diabetes drug costs are 11% of that budget.  There are around 17,000 to 18,000 people with diabetes in the Mid Essex area, of which 15,000 have type 2 diabetes. The statistical information on prescribing drugs can be found on the NHS digital website. The statistical information goes down to GP Practice level.  To download the some of the information, you may need to install an add-on in Microsoft excel.  Guidance to do this can be found on the NHS website. The information can be found at

Paula explained that diabetes drug costs have risen sharply in recent times due to new products coming onto the market, as well as a significant growth in population in the Mid-Essex area.  Paula added that metformin, which is an older drug, still out performs many of the new drugs. GP’s will nearly always give a new diagnosed type 2 diabetic needing medication metformin as it is both effective and cheap.

From April to June 2018 in Mid Essex there has been a 7% growth in costs relating to diabetes drugs. At present the cost per patient per quarter is around £80.  

The Clinical Commission Group suggests that each person with diabetes that is aged 12 and above should have 9 different checks annually.  

The care processes the NHS records are: -

1 – HbA1c (Measure of Blood Glucose)

2 – Blood Pressure

3 – Serum Cholesterol (Test for cardiovascular risk)

4 – Serum Creatinine (Test for kidney function)

5 – Urine Albumin/Creatinine Ratio (Urine test for early kidney disease)

6 – Foot Surveillance

7 – Smoking History

8 – Body Mass Index

9 – Digital Retinal Screening.

The NHS data from the National Diabetes Audit for 2016-17 shows that people with type 1 are less likely to have all their annual checks than those with type 2 diabetes.  Many people with diabetes are also missing out on tests to detect early kidney disease and foot care. 

Treatment targets are also being missed.  The audit shows that only 16.1 % of those with type one diabetes met their HbA1C, blood pressure and cholesterol targets in 2012-13 this rose to 18.9% in 2016-17. 37.3% of those with type 2 diabetes met the three treatment targets in 2012-13 and that rose to 40.8% in 2016-17. Those that are being offered structured education courses within 12 months of diagnosis is also remarkably low 3.1% of type 1 and 7.1% of type 2.  One questions why so many people with diabetes are missing their targets and why aren't newly diagnosed diabetic being offered educational courses on the condition.

The information above is dependent upon GP practices submitting timely and accurate records and therefore may not be representative of the whole diabetic population, however there is work to be done to encourage everyone to have all of their annual checks in order to maintain the best of health.

Diabetes UK issues a 15-point checklist that each person with diabetes should receive on an annual basis in order to maintain the condition successfully.  The list can be found at