DATE RECEIVED 09/10/2017 SUBJECT Formulary PASSED TO Mary DATE PASSED 09/10/2017 RESPOND BY 27/10/2017 CATEGORY Business FoI NUMBER

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1 DATE RECEIVED 09/10/2017 SUBJECT Formulary PASSED TO Mary DATE PASSED 09/10/2017 RESPOND BY 27/10/2017 CATEGORY Business FoI NUMBER Question/s to be Answered Can you please provide the following information for NHS SHETLAND 1. Does the CCG have a formulary for Blood Glucose Test Strips and Lancets Yes, Shetland Health Board does have a formulary. If so please can you provide the formulary/s or link to the formulary/s See below 2. Does the CCG have a formulary for Insulin Pen Needles No If so please can you provide the formulary/s or link to the formulary/s Is the CCG supported by CSU guidance, APC guidelines or regional or speciality guidance when forming the above formularies for BGTS, Lancets and Pen Needles Agreed with specialists at Health Board level, according to local parameters for island 3. Please advise the responsible Medicines Optimisation contact for the above formularies and their contact details Medicines Optimisation is an English process which is not undertaken in the same format in Scotland, although the same principles are applied. The best contact for NHS Shetland would be Mary McFarlane 4. Please advise the dates when the above Formularies were last reviewed and when they are set for next review. May 17, for review in 2 years

2 NHS Shetland Blood Glucose s and Strip Formulary Specific meter and test strip information can be found in the attached Reference Table Preferred List All adults with Type 1 diabetes / Select (brittle - at risk of decompensating) / All Gestational Diabetics: o 2K Can check both blood glucose and ketones All adults with Type 2 diabetes not at risk of decompensating o Cannot test ketones o Gluco Rx Nexus Voice system Audible option for visually impaired patients Second line Type 1 diabetics on Freestyle Libre system / Juvenile diabetics o Freestyle Optium Neo o Accu-chek Aviva Expert Basal bolus insulin regimens and carb counting. SMART meters help calculate insulin requirements. (Provided by diabetes specialist team only) For use with insulin pump: o Contour Next Link Used in conjunction with Medtronics insulin pump. (Provided by diabetes specialist team only) o Accuchek Aviva Combo Used in conjunction with Roche insulin pump. (Provided by diabetes specialist team only)

3 Information Blood Glucose Test Strips Ketone Test Strips Lancets Preferred 730 memory capacity Strip expiry date 9 months from Replacement batteries: 2 3V CR2032 Lithium. Contact Glucomen for free replacement batteries ( or ) sensor Glucoject Plus Lancets 33G x Preferred Type 1 diabetics testing ketones Pregnant diabetics Second Line meter with visual problems. 2K GlucoRx Nexus Voice 730 glucose and 100 ketone memory capacity. Strip expiry date 9 months from Replacement batteries: 2 3V CR2032 Lithium. Contact Glucomen for free replacement batteries ( or ) Audio feedback for visually impaired patients. Memory capacity 450 Strip expiry 6 months after sensor GlucoRx Nexus test Glucomen Ketone 9.95 for 10 Glucoject Plus Lancets 33G x Replacement batteries: 2x1.5V AAA alkaline batteries. Contact customer service: or

4 Second Line Type 1 diabetics with freestyle libre system Second Line Basal Bolus SMART meter Freestyle Optium Neo Expert 1000 memory capacity incl. Ketones Replacement batteries: Contact Abbott for free replacement: memory capacity. Replacement batteries: contact Roche customer service for free replacement: or Freestyle Optium test for 50 test for 50 Freestyle betaketone test for 10 Accuchek Fastclix Lancet x Insulin Pump (Medtronics) Contour Next Link 1000 memory capacity Strip expiry on vial. 24month shelf life. is rechargeable via USB port. USB wall charger plugs available free of charge. Contact customer services on Contour Next test for 50 As per contour next link lancing device provided. Insulin Pump (Roche) Accu-chek Aviva Combo 1000 memory capacity Replacement batteries: 3xAAA. Contact Roche customer service for free replacement: or test for 50 Accuchek Fastclix Lancet x

5 Additional Information Freedom of Information (Scotland) Act 2002 TRAINING Most meters have the same basic functions and the process to obtain a blood glucose reading is similar. However it is important that all patients are trained on how to use their meter and know: the purpose of testing how to interpret the blood glucose results and what action to take how often and when to test how to use the meter and the lancing device to achieve an accurate result when to seek advice from their healthcare professional NICE recommend that patients with type 1 & type 2 diabetes who are self monitoring their blood glucose levels have a structured assessment at least annually to include self monitoring skills. In addition to this the assessment should take account of the impact of monitoring on the person s quality of life & the continued benefit of monitoring. GOOD PRACTICE IN SELF TESTING AND STORAGE OF BLOOD GLUCOSE TEST STRIPS INFORMATION FOR PATIENTS Specific information is included in product leaflets for meters &. Self testing Ensure hands are washed with soap and thoroughly dried (with a clean towel) prior to testing. Contaminants on the skin or excess moisture can affect the accuracy of the reading. Ensure sufficient blood sample size is applied to the test strip. Do not add more blood after the first drop has been applied. Apply fresh blood drop to test strip immediately after blood drop obtained. Not testing promptly can lead to evaporation of blood drop which can affect accuracy of the reading. Do not test with a smeared or spread blood drop as this can introduce contaminants. Also, do not wipe or smear the blood drop onto the test strip, simply touch the test strip and blood drop together without excess pressure. Storage Store in accordance with manufacturer s instructions. Heat, cold, humidity and moisture can all affect how the work which in turn affects the accuracy of the reading. Keep in their original sealed container only. Ensure container lid is closed properly after each use. Check expiry dates of test and control solutions. Do not use if out of date. Most strip packaging allows the or expiry date once opened to be written on the label Store the meter and test at room temperature. Keep away from direct sunlight & heat. Do not freeze. Do not leave test in vehicles for extended periods of time as may be subject to temperature extremes. Do not bend, cut or alter test strip in any way. A Control Solution, available free from meter companies, contains a known amount of glucose and is used to ensure the meter and are working correctly. It is advised to routinely use the control solution to test the meter and if there are situations where the blood glucose test results are not as expected.

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