Type 1 moving to GB - cost of treatment

Eksen

Newbie
Messages
3
Hello everybody,

let me quickly introduce myself, I am 31 year old Type 1 diabetic, diagnosed 8 years ago, living in central europe.
As from the first day I was trying to get know as much as possible and use the latest gadget.
Since that time I tried various CGMs and insulins with no intension to be on a pump.
For quite long term I am able to be around 40 HbA1c.
Currently using:
- Tresiba
- Fiasp
- Dexcom G6

Situation: I was offered move within our company to GB and many questions start to pop-up.
What might be cost or surcharge for a treatment in my case?
I saw that Dexcom for self funders is circa 2500 GBP/year.
Is it ok to stay at the same insulins variant (are they for free?)?
Or are there many condition to be met (for e.g. certain range of HbA1c, and other factors).
My company found out, that Freestyle Libre is free of charge, which I was using as well in a past (V1). I dont want to change my CGM, as I am super happy with G6.
Currently my expenses are zero for insulin, small surecharge for Dexcom.

Thank you very much in advance everybody for your tips, hints, comments, experience :)
 
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Maco

Well-Known Member
Messages
278
Type of diabetes
Type 1
Hey,

As a UK citizen we receive our healthcare free of charge through the NHS, insulin finger pricks kits etc are all free of charge. CGM has a strict criteria & although personally I’ve never heard of dexcom being funded by the NHS I’m sure I’ve seen a few people say they get it free. Libre is readily available.

This is the supposed criteria
  • had more than one severe hypo a year with no obvious cause
  • complete hypo unawareness
  • more than 2 hypos a week, with no symptoms and which affect day to day life
  • extreme fear of hypos
  • an HbA1c level of 75mmols/mol despite testing at least 10 times a day.

I’m sure someone else will have better knowledge than me regarding how or if you will be entitled to free healthcare once you move here.
 

Rokaab

Well-Known Member
Messages
2,159
Type of diabetes
Type 1
Treatment type
Pump
As a UK citizen we receive our healthcare free of charge through the NHS, insulin finger pricks kits etc are all free of charge. CGM has a strict criteria & although personally I’ve never heard of dexcom being funded by the NHS I’m sure I’ve seen a few people say they get it free. Libre is readily available.

Note: The Libre is prescribed to only about 20% of T1's so not you are certainly not guaranteed to get it on the NHS (its very dependent on your local area as well).
 

DCUKMod

Master
Staff Member
Messages
14,298
Type of diabetes
I reversed my Type 2
Treatment type
Diet only
Hello everybody,

let me quickly introduce myself, I am 31 year old Type 1 diabetic, diagnosed 8 years ago, living in central europe.
As from the first day I was trying to get know as much as possible and use the latest gadget.
Since that time I tried various CGMs and insulins with no intension to be on a pump.
For quite long term I am able to be around 40 HbA1c.
Currently using:
- Tresiba
- Toujeo
- Dexcom G6

Situation: I was offered move within our company to GB and many questions start to pop-up.
What might be cost or surcharge for a treatment in my case?
I saw that Dexcom for self funders is circa 2500 GBP/year.
Is it ok to stay at the same insulins variant (are they for free?)?
Or are there many condition to be met (for e.g. certain range of HbA1c, and other factors).
My company found out, that Freestyle Libre is free of charge, which I was using as well in a past (V1). I dont want to change my CGM, as I am super happy with G6.
Currently my expenses are zero for insulin, small surecharge for Dexcom.

Thank you very much in advance everybody for your tips, hints, comments, experience :)

Eksen, I think it is fair to say that there are a number of factors that aren't quite clear at the moment, bearing in mind the UK's current position, relating to the EU.

After the transition period ends (on 31/12/2020), the benefits of an EHIC card and all that brings will cease.

Depending on your company's terms for those moving overseas, in your shoes, I could want to wait until the Brexit Deal/NoDeal situation was clarified.

If your country is not an EU member, then it would be worthwhile researching the current arrangements for people from your country living in UK.

If you have leverage with your company, in your shoes, I would want my company to underwrite any associated medical costs for my diabetes for at least a period of time. That period can't really be determined by me, not fully understanding your situation. It is also not clear from your post whether your relocation is for a short time, a set period, or [potentially open-endedly.

In summary, it's an "interesting" time to be looking at relocating.
 

Daibell

Master
Messages
12,642
Type of diabetes
LADA
Treatment type
Insulin
Hi. Even the Libre is not easy to get for T1s. My local said I would need to go on a waiting list and meet all the criteria. In most areas you are unlikely to have a funded Libre and even less so for Dexcom. Once you 'join' the NHS which I believe involves an up front lump sum when you are new to the UK, you should get all your medicines for free as a diabetic. Your two insulins are readily available.
 

Antje77

Oracle
Retired Moderator
Messages
19,284
Type of diabetes
LADA
Treatment type
Insulin
Currently using:
- Tresiba
- Toujeo
Is this a mistake? Both of those are very long acting insulins with roughly the same action profile, and you make no mention of a short acting insulin.
 
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Eksen

Newbie
Messages
3
Is this a mistake? Both of those are very long acting insulins with roughly the same action profile, and you make no mention of a short acting insulin.
Thank you - edited first post :)

Eksen, I think it is fair to say that there are a number of factors that aren't quite clear at the moment, bearing in mind the UK's current position, relating to the EU.

After the transition period ends (on 31/12/2020), the benefits of an EHIC card and all that brings will cease.

Depending on your company's terms for those moving overseas, in your shoes, I could want to wait until the Brexit Deal/NoDeal situation was clarified.

If your country is not an EU member, then it would be worthwhile researching the current arrangements for people from your country living in UK.

If you have leverage with your company, in your shoes, I would want my company to underwrite any associated medical costs for my diabetes for at least a period of time. That period can't really be determined by me, not fully understanding your situation. It is also not clear from your post whether your relocation is for a short time, a set period, or [potentially open-endedly.

In summary, it's an "interesting" time to be looking at relocating.

Thank you very much for this comment!
Currently I am in EU country, I would join NHS during obtaining my visa (company cost).
We are talking about relocation for the period of circa 3 years.
I found it quite challenging as well - especially with "correct" information.
Within the NHS system, apart from CGM is there anything which could be potentialy high cost?


Hi. Even the Libre is not easy to get for T1s. My local said I would need to go on a waiting list and meet all the criteria. In most areas you are unlikely to have a funded Libre and even less so for Dexcom. Once you 'join' the NHS which I believe involves an up front lump sum when you are new to the UK, you should get all your medicines for free as a diabetic. Your two insulins are readily available.
Thanks, I was looking at the criteria mentioned at some websites, but it seems that system is more oriented to "not well compensated" results rather than for the good ones. Or did I understand it in incorrect way?
 
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NicoleC1971

BANNED
Messages
3,451
Type of diabetes
Type 1
Treatment type
Pump
Thank you - edited first post :)



Thank you very much for this comment!
Currently I am in EU country, I would join NHS during obtaining my visa (company cost).
We are talking about relocation for the period of circa 3 years.
I found it quite challenging as well - especially with "correct" information.
Within the NHS system, apart from CGM is there anything which could be potentialy high cost?



Thanks, I was looking at the criteria mentioned at some websites, but it seems that system is more oriented to "not well compensated" results rather than for the good ones. Or did I understand it in incorrect way?
Hello and I hope you enjoy your move to the UK! Do you know where you will be living? From this you can determine which CCG (clinical commissioning group) will be paying for your requirements and may be able to ask the relevant pump administrator what kit they offer.
Also pumps and libre are rationed at consultant level so your first job would be to get referred to a consultant because you have had complications and/or have unstable diabetes.
Your insulin is commonly prescribed so I cannot imagine that a GP will not prescribe assuming a reciprocal prescribing system but it will benefit you to stock up no doubt. Ditto your pump consumeables and perhaps an insulin pen just in case your pump goes wrong.
I have heard that in my local CCG they were offering patients the Dexcom G6.
Most consultants and nurses seem to be very pro all the tech on offer but they do have to help you meet the criteria to justify the budget. I got my own pump (Roche) because I was being seen by a consultant and mentioned that I was pretty sporty and finding that part of diabetes difficult.
 

Eksen

Newbie
Messages
3
Hello and I hope you enjoy your move to the UK! Do you know where you will be living? From this you can determine which CCG (clinical commissioning group) will be paying for your requirements and may be able to ask the relevant pump administrator what kit they offer.
Also pumps and libre are rationed at consultant level so your first job would be to get referred to a consultant because you have had complications and/or have unstable diabetes.
Your insulin is commonly prescribed so I cannot imagine that a GP will not prescribe assuming a reciprocal prescribing system but it will benefit you to stock up no doubt. Ditto your pump consumeables and perhaps an insulin pen just in case your pump goes wrong.
I have heard that in my local CCG they were offering patients the Dexcom G6.
Most consultants and nurses seem to be very pro all the tech on offer but they do have to help you meet the criteria to justify the budget. I got my own pump (Roche) because I was being seen by a consultant and mentioned that I was pretty sporty and finding that part of diabetes difficult.
I will be living in Manchester area, it would be great to get in touch with doctor up-front to have smooth transition from doctor to doctor :)
 

NicoleC1971

BANNED
Messages
3,451
Type of diabetes
Type 1
Treatment type
Pump

phoenix

Expert
Messages
5,671
Type of diabetes
Type 1
Treatment type
Pump
I think that you may need to try to bring with you several months worth of consumables. I moved back to the UK from France a couple of years ago. I'm British but even so there was some paperwork moving back to the NHS. I had about 10 months supply of consumables (some I had just accumulated and some that my 'pump' nurse very kindly and I have to say surreptitiously donated to me ). It took about a month to get myself organised and to see the GP. No problem with her prescribing insulin, strips and other medications . I showed her my prescription but had to transcribe and translate it for her (it was handwritten) Then it was another 4 months to get to see the consultant. He then had to get authorisation for the costs associated with pump use. About 5 weeks later I saw the specialist nurse who set up my account with medtronic. So I needed 6-7 months supplies of consumables.
Waits to see the consultant may be longer next year. My last appointment at the hospital was September a year ago. I've had one video appointment with a specialist nurse since then. My next appointment with the consultant will be a video appointment in February next year.
I had a Libre on prescription in France but not here.
 
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