There is only one reason for test strips being limited or being limited to a small set of meters....
- The NHS monies are controlled by CCGs (Clinical Commissioning Groups) and these are being controlled by PENNY PINCHING BEANCOUNTERS rather than CLINICIANS i.e. Accountants (but NOT Actuaries) rather than Doctors/Nurses/Patients (Actuaries live in the (usually life assurance)/ insurance world and work with actual data) rather than the beancounting accountants that work with guess-estimates (usually bad ones).
Some CCGs are trying to limit use by T1's and T2's to specific meters such that the test strips cost £10 or less per prescription item.
If your doctor changes your meter and prescription to comply with the bean counters, question their actions !!!
The best cudgel to apply is usually that of DVLA Medical and testing for driving, otherwise the cost of failing to prevent expensive surgery.
I have a spreadsheet - its a .
numbers file (mac spreadsheet) from data in the Drug Tariff - "Appendix IXR - Chemical Reagents" The June 2014 edition (it is published 3 working days before 1st of the month) and it shows that 67 reagents can be prescribed on NHS prescriptions, 7 are for urine tests for glucose, ketones, and proteins, 2 for colorimetric testing of blood without a meter, (i.e. compare the reagents colour change after a specified reaction time against a colour chart), 2 reagents for blood ketone testing (using a BG meter, 3 meters can be used for both BG and Ketone tests) , 3 reagents for INR (blood thinning therapy - treated with warfarin etc), 1 for neuropathy, which leaves 53 BG meter reagents. This means a total of 62 out of 67 reagents are exclusively for diabetics.
This data shows the cost the NHS pays per prescription item for SMBG (usually ~50 tests, i.e. 25, 50(2x25), 50, 51(3x17), 60(15x6), 100(2x50)) ranges from £4.50 to £31.90 or 14p to 33p per test. (The retail cost of the £31.90 prescription item (100 tests) is £27.99 for 50 tests, less the VAT exemption)
- The cost of SMBG (Self Monitoring of Blood Glucose) is less than £70 per month.
- The cost of a leg amputation in excess of £32,000 for a leg amputation in the first year
- The cost of treatments for diabetic retinopathy can exceed £2,000.
For the CCG beancounter types, go figure. Which is cheaper?
-
correct answer is SMBG at less than £70 per month
Also take note that DVLA Medical requires an annual 3-stage assessment for all
Class 2 drivers on insulin i.e.
Lorry,
Bus and
Coach drivers, (and many local authorities require this of
Taxi drivers also) BG testing results for 90 consecutive days to be seen by ones Diabetes Clinic (either Hospital or GP run-Satellite clinics) and an independent assessor appointed by DVLA (55 of these - all consultant Diabetologists/Endocrinologists, who have NOT been involved in your treatment, most are Hospital Diabetes Unit Clinical Leads) at least 2 tests per day, 7 days a week and every 2 hours at times relevant to driving, which means BG meters with at least 750 memories.
They also expect this level of testing for car/motorcycle drivers on insulin (every 2 hours relevant to driving) and T2D Class 2 drivers on BG lowering oral medications. A professional driver is likely to be needing to do at least 30 tests per week.
scores in trust of opinion
- Accountants = 1 star,
- Actuaries = 2 stars,
- Informed Patients = 3 Star,
- GPs = 3 to 4 stars, DSNs = 3 to 4 stars,
- Surgeons and Diabetologists/Endocrinologists 5 Stars