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MEDICINES OPTIMISATION IN DIABETES Yvonne Parker Medicines Optimisation Pharmacist

MEDICINES OPTIMISATION IN DIABETES Yvonne Parker Medicines Optimisation Pharmacist Stoke-on-Trent CCG. Current Prescribing Trends. Figures taken from PrescQIPP Drugs used for diabetes snapshot 2014/15 – April to January. Growth by BNF chapter – Actual Growth Cost.

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MEDICINES OPTIMISATION IN DIABETES Yvonne Parker Medicines Optimisation Pharmacist

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  1. MEDICINES OPTIMISATION IN DIABETES Yvonne Parker Medicines Optimisation Pharmacist Stoke-on-Trent CCG

  2. Current Prescribing Trends Figures taken from PrescQIPP Drugs used for diabetes snapshot 2014/15 – April to January

  3. Growth by BNF chapter – Actual Growth Cost Top 6 BNF chapters (highest to lowest growth cost):

  4. Endocrine System Growth Actual growth April to February 13/14 vs 14/15

  5. Top 10 Diabetes Drugs/Reagents by Cost

  6. Main areas of concern Stoke-on-Trent • 2,000% (£18,500) increase in insulin degludec • 250% (£5,600) increase in combination product sitagliptin/metformin (Janumet) North Staffs • 365% (£10,000) increase in insulin degludec • 11% (£10,000) increase in liraglutide

  7. Main areas of improvement Stoke-on-Trent • Decreased spend on non-formulary drugs • Decreased spend on BGTS • Decreased spend for 3 combination products North Staffs • Decreased spend on non-formulary drugs • Decreased spend for 3 combination products

  8. North Staffordshire Joint Formulary • AIMS: • To promote safe, effective and economic prescribing in both primary and secondary care • Help to ensure seamless prescribing, thereby reducing possible errors and confusion • Each section approved by the North Staffordshire and Stoke-on-Trent Area Prescribing Committee

  9. Medicines are categorised according to a traffic light system The formulary can be found at: http://www.stokeccg.nhs.uk/joint-formulary

  10. GLP-1 mimetic prescribing and ESCAs • 1st line – Byetta (exenatide twice daily) • 2nd line – Bydureon (exenatide once weekly) • 3rd line – Victoza (liraglutide once daily) Essential Shared Care Agreements (ESCAs) set out specialist, GP and patient responsibilities and are required due to the amber 1 classification of GLP1s on the formulary

  11. GLP-1 mimetic prescribing and ESCAs 7 GP practices in Stoke are taking part in the GLP1 LIS service Prescribing needs to be in line with NICE guidance • Triple therapy – 1.0% reduction in HbA1c and 3% reduction in weight 6 months after initiation • Dual therapy – 1.0% reduction in HbA1c 6 months after initiation

  12. Guidelines for diabetes • Management of adults with diabetes mellitus – Guidelines for clinical care • At-a-glance guide for self monitoring blood glucose (SMBG) in diabetes • Patient guide for self monitoring of blood glucose (SMBG) in diabetes • At-a-glance guide for treatment with a 3rd line oral agent for patients with type 2 diabetes

  13. Medicines OptimisationProjects • Prescribing of WaveSense JAZZ BGTS and supplying the meter to all suitable patients • Prescribing of Omnican Fine or GlucoRxFinePoint pen needles to all suitable patients • A review of the prescribing of 3rd line oral antidiabetic agents in the management of type 2 diabetes

  14. Any questions?

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