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25-09-2011 | General practice | Article

Synthetic insulins ‘waste NHS funds’

Abstract

BMJ Open 2011; 2: e000258 / Free full text

Prescribing insulin analogues instead of human insulin could be wasting the NHS large sums of money, report researchers.

They say that the newer, synthetic forms of insulin have become increasingly popular, despite being very expensive and offering patients only modest benefits.

The team, led by Professor Craig Currie from Cardiff University, calculated the cost to the NHS of prescribing insulin analogues instead of human insulin over the period 2000 to 2009.

As reported in BMJ Open, the NHS spent a total of £2,732 million on insulin over this period, with prescriptions for insulin analogues accounting for £1,629 million, or 59%, of the total.

Assuming that all patients who received insulin analogues could have received human insulin - and discounting whether presented as a phial, pen or pen-fill device - the NHS could have saved an estimated £625 million, report Professor Currie and colleagues.

Currently NICE guidelines recommend human neutral protamine Hagedorn insulin as first-line therapy, while insulin glargine is only recommended in certain circumstances.

Professor Currie and team write: "While it has been shown that insulin analogues are associated with reduced weight gain, less hypoglycemia (particularly nocturnal), improved lowering of postprandial glucose and improved dosing schedules, most commentators agree that these benefits are modest in comparison to human insulin."

Although they concede that, for example, rapid-acting insulin analogues may be cost effective in patients with type 1 diabetes, the researchers conclude: "It is likely that there was and is considerable scope for financial savings."

GP News is an independent clinical news service provided by Springer Healthcare Limited. © Springer Healthcare Ltd; 2011

By Caroline Price