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Journal of Public Health Advance Access published online on November 23, 2006
Journal of Public Health, doi:10.1093/pubmed/fdl076
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© The Author 2006, Published by Oxford University Press on behalf of Faculty of Public Health. All rights reserved

Article

Trends in the prescription and cost of diabetic medications and monitoring equipment in England 1991-2004

Hitesh Patel 1, Janakan Srishanmuganathan 2, Josip Car 3 *, and Azeem Majeed 3

1 Charing Cross Hospital, London W6 8RF, UK
2 Chelsea and Westminster Hospital, London SW10 9NH, UK
3 Department of Primary Care and Social Medicine, Imperial College, St Dunstan’s Road, London W6 8RF, UK

* To whom correspondence should be addressed.
Josip Car, E-mail: josip.car{at}imperial.ac.uk


  Abstract

Background To report the trend in prescriptions and cost of antidiabetic drugs and glucose monitoring equipment in England from 1991 to 2004.

Methods We analysed data on all community antidiabetic drug prescriptions in England collated from the Prescription Cost Analysis system.

Results The total number of diabetes prescriptions (medicines and monitoring) rose from 7 613 000 (1991) to 24 325 640 (2004) (>300% increase). Meanwhile, total costs increased by 650%. Insulins are the biggest contributor to cost followed by monitoring equipment and then oral medications. Three times as many items of oral tablets are prescribed than insulins. Metformin accounts for 40% of all diabetic drug dispensations but only 7% of the costs. More is spent on glitazones now than on either metformin or sulphonylureas.

Conclusions There has been a substantial increase in the cost of managing diabetes in the community. Costs are likely to continue to rise in the future, as the prevalence of diabetes increases and through more aggressive identification and management of patients with diabetes in the hope of reducing the even more costly complications. The cost implications of glucose monitoring merits further study.

Keywords: costs and cost analysis, diabetes mellitus, drug costs, economics, pharmaceutical preparations.
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