Real-world data analysis of general practice prescribing (GPP) to highlight the growing challenges in application of appropriate medication for Type 2 diabetes

HEALD, AH; Livingston, M; Fryer, A; Cortes, MGY; Bien, Z; Gadsby, R; Ollier, W; Stedman, M; Young, RJ

Abstract

Objective: GP apply the wide variety of Type 2 diabetes medications at different rates. Our aim was to see if there are lessons to be learnt from analysing in detail these variations.

Methods: England GPP and Quality Outcome Framework data over that last five years were combined with WHO/ATC defined daily dose (DDD) of non-insulin BNF ‘other diabetic medication’ by chemical, combination and dose. Each medication was classed by growth relative to previous year; ‘growing’ (GR) (>7% pa), ‘static’ (ST) (−3% to 7% pa) and ‘less used’ (LU) (below −3% pa). GP were then classified HI and LO by % DDD of GR and LU therapies vs median.

Results: In 2016–2017 for 2.8 million patients with Type 2 diabetes, the total BNF ‘other diabetic medication’ actual cost was £410 million, 3.9 million DDD and 83 different medications (40 GR (£190 million/year and 790,000 DDD), 37 LU (£50 million/year and 450,000 DDD), 6 ST (£170 million/year and 2.6 million DDD). The overall average in 7,600 practices was 31 different medications in a year of which 14 were GR and 12 LU. Use of ST varied from 0.6 to 1.4 DDD/patient. Practices split by prescribing mix into 33% HI-GR/HI-LU, 33% LO-GR/LO-LU, 17% LO-GR/HI-LU, 18% HI-GR/LO-LU. On average, HI-GR/LO-LU practices spent 5% more/patient, used 2% less DDD/head with 7% higher £/DDD; LO-GR/HI-LU practices spent 8% less/patient, used 2% more DDD/head at 10% lower £/DDD; LO-GR/LO-LU spent 2% more/patient due to 2% higher £/DDD; HI-GR/HI-LU were close to median on these indicators.

Conclusion: GP practices behave significantly differently in their choice and application of Type 2 diabetes medications. Local priorities and capabilities vary and so changing behaviour would need different approaches for different types of practices.

Citation

HEALD, A., Livingston, M., Fryer, A., Cortes, M., Bien, Z., Gadsby, R., …Young, R. (2018, March). Real-world data analysis of general practice prescribing (GPP) to highlight the growing challenges in application of appropriate medication for Type 2 diabetes. Poster presented at Diabetes UK Professional Conference 2018, London ExCeL, London, UK

• Presentation Conference Type: Poster
• Conference Name: Diabetes UK Professional Conference 2018
• Conference Location: London ExCeL, London, UK
• Start Date: Mar 14, 2018
• End Date: Mar 16, 2018
• Deposit Date: Jun 27, 2023
• Publisher URL: https://onlinelibrary.wiley.com/doi/10.1111/dme.58_13571