- Messages
- 8,934
- Type of diabetes
- Type 1
- Treatment type
- Other
Over the past six months I've been undertaking an experiment in the use of blood glucose testing strips alongside using CGM and an Artificial Pancreas system. The last prescription I got from my GP was for 400 strips on the 16th August, so let's assume I started to use those on 1st September. Significantly more than I was expecting, but I'm okay with that.
Just for qualification here, I don't drive frequently (typically twice a week), but I do use the gym a few times per week. I'm using the Contour Next strips as a consequence of officially being on the 640G pump, so these cost around £15 according to the NHS BSA tariff.
The CGM I've been using is, for the most part, the Dexcom G5. I have one box of strips that remains unopened, and about 15 left in my current pot. This means I have used, to this point, 635 test strips. Over the period of 153 days, this means I've used an average of 4.2 test strips per day. This equates to a spend of £193.
To achieve the same level of management, I'd be on the 10 strips per day model, which would work out at £459 over the period. This equates to a saving to the NHS of £266. Or a total of 5 dexcom sensors every 5 months. If we extrapolate that out, we end up at a saving of £638. If we were to follow the lead of a number of CCGs and move to the cheaper strips (£9.99 for 50) this would equate to a saving of roughly £421. At the current rate, that's eight sensors plus a bit.
My usual sensor coverage lasts 14-18 days, so let's take 16 days as the norm. Over the course of the 12 month period, this would enable me to get four months of sensors.
So what's my point. In spite of the masses of data, and the fact that I'm able to manage my levels far better with this technology, the benefits of this are not easily costable in the NHS model.
Looking at it purely from a total cost perspective, I'd need to be using far more strips per day using SMBG (based on the £9.99 for 50 strips, that's more than 15 per day) to get anywhere near the costs of funding Dexcom sensors, let alone the transmitter. None of the studies in the NICE guidance come anywhere near demonstrating that 15 strips per day makes a cost effective difference...
As a footnote, I'm aware that Partha Kar has been tweeting about getting closer to something with Abbott in relation to the Freestyle Libre. I'm hopeful that they've been able to demonstrate Hb1C improvements, in line with the recent CGM studies that were published and that NICE recognises that this leads to fewer costs and improved life quality as a way of benchmarking this stuff.
Just for qualification here, I don't drive frequently (typically twice a week), but I do use the gym a few times per week. I'm using the Contour Next strips as a consequence of officially being on the 640G pump, so these cost around £15 according to the NHS BSA tariff.
The CGM I've been using is, for the most part, the Dexcom G5. I have one box of strips that remains unopened, and about 15 left in my current pot. This means I have used, to this point, 635 test strips. Over the period of 153 days, this means I've used an average of 4.2 test strips per day. This equates to a spend of £193.
To achieve the same level of management, I'd be on the 10 strips per day model, which would work out at £459 over the period. This equates to a saving to the NHS of £266. Or a total of 5 dexcom sensors every 5 months. If we extrapolate that out, we end up at a saving of £638. If we were to follow the lead of a number of CCGs and move to the cheaper strips (£9.99 for 50) this would equate to a saving of roughly £421. At the current rate, that's eight sensors plus a bit.
My usual sensor coverage lasts 14-18 days, so let's take 16 days as the norm. Over the course of the 12 month period, this would enable me to get four months of sensors.
So what's my point. In spite of the masses of data, and the fact that I'm able to manage my levels far better with this technology, the benefits of this are not easily costable in the NHS model.
Looking at it purely from a total cost perspective, I'd need to be using far more strips per day using SMBG (based on the £9.99 for 50 strips, that's more than 15 per day) to get anywhere near the costs of funding Dexcom sensors, let alone the transmitter. None of the studies in the NICE guidance come anywhere near demonstrating that 15 strips per day makes a cost effective difference...
As a footnote, I'm aware that Partha Kar has been tweeting about getting closer to something with Abbott in relation to the Freestyle Libre. I'm hopeful that they've been able to demonstrate Hb1C improvements, in line with the recent CGM studies that were published and that NICE recognises that this leads to fewer costs and improved life quality as a way of benchmarking this stuff.
