Prescribing data, metrics or supporting resources
The selection of metrics to support key therapeutic topics is overseen by the NHS England Medicines Optimisation Intelligence Group, and work is ongoing in this area. At this point, the following prescribing data and metrics have been identified by this group to support this topic.
The NHS Digital report Prescribing for diabetes, England: 2007/08 to 2017/18 found that in the financial year 2017/18 there were 53.4 million items prescribed for diabetes at a total net ingredient cost of £1,012.4 million. This represents an additional 22.6 million items (73% relative increase) and an additional £421.7 million (71% relative increase) compared with 2007/08. The prescribing of 'other antidiabetic drugs' (which includes the newer blood glucose lowering drugs) has increased considerably in recent years. The number of items prescribed increased by 250% (6.7 million) from 2007/08 to 2017/18 with a growth in net ingredient cost of 224% (£250.2 million).
The net ingredient cost of all insulin therapy in primary care in 2017/18 was £350.5 million; a growth of 31% from 2007/08. In the financial year 2017/18, 1.5 million items of insulin glargine were prescribed at a cost of £82 million, 700,000 items of insulin detemir were prescribed at a cost of £41 million and 160,000 items of insulin degludec at a cost of £10 million. This compared with 600,000 items of NPH (isophane) insulin at a cost of £19 million.
A medicines optimisation key therapeutic topic (MO KTT) prescribing comparator is available on long-acting insulin analogues.
Several diabetes metrics related to this key therapeutic topic are also included in the Medicines optimisation dashboard, which brings together a range of medicines-related metrics from across sectors. These are:
Diabetes Mellitus (DM009) % achieving upper threshold or above, which is the percentage of practices in a clinical commissioning group (CCG) that achieve upper threshold or above (92% or more inclusive of exceptions) for quality and outcomes framework indicator DM009.
Diabetes Mellitus (DM009) % underlying achievement, which is the percentage underlying achievement at CCG level for QOF indicator DM009 inclusive of exceptions.
Emergency diabetes admissions, which is the number of emergency attendances for diabetes per 100 patients on the practice QOF diabetes disease register.
The medicines optimisation dashboard helps NHS organisations to understand how well their local populations are being supported to optimise medicines use and inform local planning. The dashboard allows NHS organisations to highlight variation in local practice and provoke discussion on the appropriateness of local care. It is not intended as a performance measurement tool and there are no targets.