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GPs spending 10% of their Medicine Budget on Diabetes

and / or if big pharma stopped making obscene profits from diabetes medications and blood glucose test strips
 
Once more an article saying obesity is driving diabetes. No mention of the sums for type 1 separate from type 2. No mention of the sums for those who got type 2 from medicine or illness. No mention of any of the other factors driving diabetes. No mention that obesity is a consequence of type 2.

Still, its the Daily Mail, init.
 
At the election I sent a long referenced document, around 19 pages to all of the MP's in one of the parties providing what I hope was a realistic estimation of potential savings - 1 responded saying it was interesting.
 
badcat said:
big pharma stopped making obscene profits from diabetes medications
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Just as well we don't live in the US. The pharmaceutical companies will cite their R&D costs as being their excuse for making huge profits. List prices in non-US countries average 41 percent of US net drug prices for the 15 companies that sell the 20 top-selling drugs in the US, with a range from 38 percent in the UK to 52 percent in Denmark. Overall in 2015 the premium earned by US net prices exceeding other countries’ list prices generated $116 billion, while that year the companies spent just 66 percent of that amount, or $76 billion, on their global R&D.

Perhaps we should also look at the cost of prescribing statins which seems to be almost automatic for someone with diabetes, whatever their cholesterol levels, and if the Daily Express is to be believed, it is to be prescribed to everyone over 60.
 
My father in law who has absolutely nothing up with him but is age 73 had the health mot they had pestered him to go to. And suprise they prescribed statins - he picked up his free pills Googled them and put them in the bin. Waste of money - there is nothing wrong with him.

Sent from my SM-G900F using Diabetes.co.uk Forum mobile app
 
Bon83 said:
he picked up his free pills Googled them and put them in the bin. Waste of money - there is nothing wrong with him.
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Unfortunately part of the problem is waste. There are many people who pickup their prescriptions and then put them in the bin. Hopefully your FIL won't collect another prescription. My MIL throws her statins in the bin every 2 months, she's 90 and there's a part of my head that says if you can reach 90 with your cholesterol the way it is, why try and change it. What I have tried to tell her is that she should tell her GP that she doesn't want or need them at her age, but she doesn't want him to give her a lecture and so throws them away.
 

It seems that about 1/3 of cardiovascular disease is people who are already known to have Type2, with anther 1/3 being people will issues with insulin resistance (carb intolerance) who have not yet been labeled Type2.


To cover the cost of R&D (and payments to doctors to enable doctors to learn about new drugs) the pharmaceutical companies do need to make that much money. Most pharmaceutical companies are now only doing research that is likely to result in sales in the USA (hence a lot of them have closed down their UK R&D labs). Lets be very glad that the USA health insurance companies are willing to indirectly fund the research that should be funded by governments.

When I lived in Cambridge I had lots of friends who work for pharmaceutical companies, they expected to spend up to 10 years doing research on a possible new drug knowing that less than 10% of research will result in anything of benefit. Hence you must remember how much risk pharmaceutical companies are taking by doing research, companies will only take large risks if there is a possibility of it resulting in very large profits.

This issue with governments not funding research is one of the reasons we have never had the large scale studies done in a way that will convince most GPs of LCHF. Setting up a 5 year randomised study on the effect of LCHF is hard enough without having no funding to do it……..

The hope we now have is that there is one USA base company that is doing large scale doctor supported LCHF funded by the USA health insurance “system”, they seem to be willing to except payment based on savings on Insulin and other drugs. This company has lots of backing from venture capitalist who see it as a way to print money and normally invest in IT companies. Like most venture capitalist back companies they are likely to fail, but if they don't fail they will transform the treatment of Type2 in the USA, and hence the rest of the world.


The best option may be to hand back the packets at collection time to the chemist that way the GP will not get fined by the NHS for not prescribing satin to enough people.
 
From my time working in the nhs its not so much a case of gps being fined for not prescribing statins, rather of them not being given incentive payments - same effect on gp income but totally different premis - with one model you get fined for not doing something that is (should be ) evidence based and beneficial to the individual patient, with the other you earn more money the wider you cast the net and the more patients you trap in it
 
Dr David Unwin (our very own @Southport GP ) has some figures on how much saving his practice makes by making diet and lifestyle changes for T2s that result in lower prescription costs. I am afraid that I don't have the current figures, but a year ago I saw him speak at a conference where he was quoting savings in excess of £40,000/yr for his practice.

Multiply those potential savings across every practice in the UK and that is a LOT of money.

Also, @Administrator has done some impressive number crunching on the reduction in drug costs when people follow the Diabetes.co.uk Low Carb Program, but I do not have the recent figures for that either.
 

Dr David Unwin did not include the cost of hospital based care, or none diabetes related prescriptions, or the cost of diabetes eye tests etc saved for people who are no longer on the diabetes register. If my wife (a NHS costing accountant) was given the task of working out what he has saved the NHS, (along with at least 3 months with no other work) I expect she would be able to justify a number at least double what is claims. Unless the cost of people living longer is included…… (All improvement in Type2 outcomes cost the NHS money due to increased length of life. Hence it is important to look at cost per year of qualify adjusted life.)
 
ringi said:
To cover the cost of R&D (and payments to doctors to enable doctors to learn about new drugs) the pharmaceutical companies do need to make that much money.
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I'm fairly familiar with the cost of R&D, my wife worked for G.D.Searle and has spent 35 years as a patent agent dealing with pharmaceutical companies and very familiar with their costs, having conducted several "due diligence" investigations for most of the larger pharmaceutical companies. She told me that most drugs will cost about £1 billion from start to shelf. Patent applications and defending those patents are part of the ongoing overall cost. I think it was Tony Benn who suggested all UK R&D should be state controlled, then there's the problem of state involvement but his idea was that companies don't make huge profits at the NHS's expense.

ringi said:
The best option may be to hand back the packets at collection time to the chemist that way the GP will not get fined by the NHS for not prescribing satin to enough people.
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I agree she should hand them back before she leaves the pharmacy. As for the NHS fining GPs where does that come from. I'm not saying they don't but I'd like some empirical evidence. There few GPs working for the NHS, most are either in partnership, running their own business and paid by the NHS, or they may work for other doctors. If you look at the present structure of our GP surgeries they are geared up to go private at the drop of a hat.
 
DavidGrahamJones said:
I think it was Tony Benn who suggested all UK R&D should be state controlled, then there's the problem of state involvement but his idea was that companies don't make huge profits at the NHS's expense.
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Would not help unless the USA reformed their health care system and did the same with R&D.......... (The UK market for drugs is not much more then a rounding error compared to the USA.)


Part of the payment PG partnerships get is depended on them hitting all the quality of car targets, one of the targets is that satins are prescribed to defined groups of people, including most people with Type2.
 
My friend is a pharmacist. She says that once the prescription is made up and labelled, it has to be binned, even if the customer hasnt opened the paper bag containing the prescription items.

The best thing to do to stop waste is cross out the items you dont want before handing the prescription to the pharmacist.
 
Yes thats what happened when i returned an unused, unwanted prescription item
 

But WHY does it have to be binned? That is what I find is sheer madness. If the blister pack, carton, bottle, or whatever is still sealed, with no evidence of tampering, then surely it must still be safe? I remember just before my mother died she had been issued with a new set of medications, on top of what was already unused & unopened at home. After her death I tried to return two large bags of perfectly good, and expensive, medications to the pharmacy, and they told me they would all have to be destroyed - I was appalled. What a criminal waste. I can understand the need for caution about items being infected with some kind of nasty, but what's the % likelihood that ordinary jo blogs will do something crazy? Has a true risk assessment of that ever been done? I'll probably get shot down for this, but even using unneeded items for poorer countries in desperate need of help must surely be better than throwing away good stuff. In truth I think 'clean' items should just be returned to stock.

If the NHS is so short of money, and continually demanding the Govt. provide extra funding, what's the point when so much of that funding is chucked down the incinerator? I honestly believe there is enough funding - it's just not used properly.


edit: Forgot to say that the costs of returned items could then be re-credited to the GP practice that initially prescribed the medication.
 
I think the best thing to do is to explain the GP that are some unwanted items and why.
If the doctors still insist on the prescription I think it's better to find another one because if one does not trust his toctor the problem are way higher than wasted prescriptions.
 
Salvia said:
But WHY does it have to be binned? That is what I find is sheer madness. If the blister pack, carton, bottle, or whatever is still sealed, with no evidence of tampering, then surely it must still be safe?
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If you pay fully fror the prescription, and the box is clearly not tampered the phamacy here could take it back, except for things like vaccines that must be kept in a cool place, If the prescription is paid by the SSN is forbidden because that was used to make a big tax scam. Once you have made an inventory unbalance, you can easily cook the books for you and friends...
 
ringi said:
one of the targets is that satins are prescribed to defined groups of people
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Is the target that statins are prescribed or that patients have cholesterol levels within certain limits? I've seen the latter documented, but not the former.
 
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