Updated NICE T1 guidelines published

[tim2000s]

Alternatively, they could grow "huge gonads" (lol ...thanks Spiker) and tell Dexcom etc that they will approve 200,000 IDDS per annum (2/3'ds of the IDDS population) for a 5-10 year contract if the price = ...

Dexcom etc would be foolish not to accept as the guaranteed demand will enable them to increase productivity and efficiency.

Oh, I presume you aren't thinking of the NHS here, who can't seem to come up with a country wide agreement for test strips, let alone CGM sensors....

 

[Scardoc]

The thing is, if you are testing at 10 times per day and you are adhering to the guidelines to replace lancets every time, then you are spending £1800 of the NHS's money annually if you are using AccuCheck Aviva test strips and the fastclix lancets (at NHS prices).

A Libre costs (at retail, not NHS, prices) £1,290 per annum, and a Dexcom using xDrip without purchasing a receiver (or maybe the G5 with smartphone app) costs around £1,600 per year.

If you are driving a lot then perhaps there needs to be some work with the NHS and DVLA to understand how the CGM model works, but the costs are not as prohibitive in relation to finger prick testing as everyone seems to think.

By the way, I fall into the high volume of testing line to keep my bg levels on track.

I am going to have to dispute the £1800 annual figure and then quickly rush off to send the NHS my CV as I think (based on that figure) I have the potential to save them £248.75 per T1!!

A very quick 2mins on Google and I can buy your AccuCheck test strips and Fastclix lancets for £0.425 per test (£18.99 for 50 strips and £9.18 for 204 lancets) and that's without haggling or bringing spending power into it. If the NHS pays anymore than 25-30% of this retail price then there needs to be a Chilcot style enquiry!

If every T1 tested 10 times a day then 3.9M test strips a day would be required. That, per annum, is a figure neither myself or my calculator can get to grips with......something like 1,423,500,000...what's that? 1.4235 billion? Even if you assume the average is a third of that in reality then it's still 427M strips a year. If the NHS don't pay pennies per strips then something is badly, badly wrong.

Driving down the cost of strips could do two very important things:
1. Free up more money for CGM where needed.
2. Allow T2's to have free access to them as well.

 

[Angusc]

If you include the 999 callouts + days in hospital the relative cost s drop as a 999 callout is £400+ and a day in hospital is £600+ those are the cost my DSN quoted 4 years ago on my CGM and pump bid and it was given because the pump + CGM were cheaper than the 6+ 999 calls and the stays in hospital, As I've not been admitted since for diabetic problems for the last 4 years.
CGM + pump saves the NHS money

 

[tim2000s]

A very quick 2mins on Google and I can buy your AccuCheck test strips and Fastclix lancets for £0.425 per test (£18.99 for 50 strips and £9.18 for 204 lancets) and that's without haggling or bringing spending power into it. If the NHS pays anymore than 25-30% of this retail price then there needs to be a Chilcot style enquiry!

The NHS payed around £17 per 50 on most of the big brands when I looked last year. The current prices are here: http://www.drugtariff.nhsbsa.nhs.uk/#/00241786-FA/FA00241579/Part IXR - Chemical Reagents
And are £15-£16 per big brand.

The price of all Pharmacy goods to the NHS is available here, pre- any discounts.

What this also demonstrates is that the well known brands are 50% more expensive than GlucoRX and MyLife. If everyone was happy to use only those, then you'd save a huge amount on test strips.Your Roche pump or Omnipod might not work, but hey, well!

 

[Scardoc]

The NHS payed around £17 per 50 on most of the big brands when I looked last year. The current prices are here: http://www.drugtariff.nhsbsa.nhs.uk/#/00241786-FA/FA00241579/Part IXR - Chemical Reagents
And are £15-£16 per big brand.

The price of all Pharmacy goods to the NHS is available here, pre- any discounts.

What this also demonstrates is that the well known brands are 50% more expensive than GlucoRX and MyLife. If everyone was happy to use only those, then you'd save a huge amount on test strips.Your Roche pump or Omnipod might not work, but hey, well!

Thanks for the link, very interesting! I've recently been moved from OneTouch Ultra (£11.99 p/50) to TrueYou (£9.92 p/50) so am saving 4p per test and glad I wasn't on a £17 strip! I see there is also a volume discount that can be obtained but am surprised that it's only 5.6-11.2%.

There are enough options there for £10 or less so I fail to see why the more expensive names aren't cast aside!

 

[tim2000s]

There are enough options there for £10 or less so I fail to see why the more expensive names aren't cast aside!

They don't work with pumps (Bayer Contour Next strips are required for Medtronic or Animas, and Abott Optium or Freestyle Lite strips are required for Omnipods, while Roche pumps use Accucheck strips).

Likewise, if reliant on a bolus calculator, then you are limited (Accuchek Expert or Abbott Freestyle).

Hence why they remain on the lists. And then there are other questions that can be asked.

I fund the Libre sensors, for example, and they use the Abbott Optium test strips at £15 a pop. As a result of funding it, my Hba1C is now non-diabetic and my SD has dropped, a lot. I therefore intend to maintain using the more expensive strips as I am saving the NHS money in the long run out of my own pocket and I don't want to carry more than one meter.

 

[Spiker]

The Accu Chek Compact is another premium meter but I am reliant on its convenience (50 strip cassette, no mess to dispose of, integrated lancet, one hand one step operation, fast test time, minimal blood drop). Without this I just would not test as often, in as many places, particularly in the workplace.