DIABETES PATIENT STRATIFICATION AND TESTING SAVING MONEY, SAVING LIVES Contents 2 The Rising Cost of Diabetes 5 Implementation 3 P atient Stratification is the Key to Saving Lives and Money 6 M eeting Clinicians Needs 4 Cost Savings 7 Meeting Patients Needs Call: 0800 243 667 Email: glucomen@menarinidiag.co.uk
Diabetes is a Major Problem in the UK n 3 million people in Britain are already diagnosed with diabetes(1,2) n Somebody is told that they have diabetes every 3 minutes in the UK(1,4) n 8 50,000 people with diabetes have not been diagnosed yet(1,3) n A further 7 million people are currently at risk of developing diabetes(1,2) Country Prevalence Number of People England Scotland Wales Northern Ireland 5.5 % 4.3 % 5.0 % 3.8 % 2,455,937 223,494 160,533 72,693 Diabetes is Very Expensive n N HS spending on diabetes was 10 billion in 2010(1) n Over 200 million is spent every year on blood glucose testing alone(5) n This is 1million per hour 10% of NHS budget(1) n With diabetes prevalence set to double in the next 15 years the cost to the NHS is rising dramatically(1) n People with diabetes account for around 19% of inpatients and have a 3 day longer stay on average(1) Blood Glucose Monitoring is a Major Cost Typical CCG spend on blood glucose strips is over 800,000 n Nearly impossible for CCGs to control costs n Patients can acquire multiple inappropriate meters from several sources n Consumer marketing campaigns drive up costs that are paid by the NHS n In some cases patients are testing unnecessarily 1. NHS Diabetes: Implementing Local Diabetes Networks, 2013. 2. Diabetes UK (2011). Diabetes in the UK 2011-12 Key Statistics on Diabetes. Available at http://www. diabetes.org.uk/documents/reports/diabetes-in-the-uk-2011-12.pdf. 3. Figures based on data from AHPO diabetes prevalence model figures http://www.yhpho.org.uk/resource/ view.aspx?rid=81090 and the QOF 2010 figures http://bit.ly/prevalence2010. 4. This figure was worked out using the diagnosed figure from the 2009 Quality and outcomes framework with figures from the 2010 Quality and outcomes framework: Quality and Outcomes Framework (QOF) 2009: England. 5. (IMS Health, Jan 2013). 02
The GlucoMen Patient Stratification Solution An Approach to Reduce Hospitalisations and Prescribing Costs STEP 1 Classify diabetes patients according to clinical need Patient Group % of Total Improved outcomes with cost benefits Type 1 Diabetes 8 Mealtime insulin adjustment Avoid DKA Avoid DKA fatality Avoid emergency hospitalisations Using Insulin 27 Avoid hypoglycaemia Plan meals and exercise Avoid costly complications Reduce prescription costs High Risk Tablets* 15 Monitor treatment and avoid complications Low Risk 40 No need to test Diet and Exercise 10 No need to test Clinical reason to test STEP 2 Offer appropriate testing to meet patient, clinician and financial goals Patient Group % of Total Type 1 Diabetes 8 Using Insulin 27 High Risk Tablets* 15 OPTION 1 OPTION 2 Reduce Prescribing Costs & DKA Reduce Prescribing Costs Save Lives and Money Save Money Monitoring Choice Typical Outcomes Glucose meter with 1. Half DKA hospitalisations ketone function Fully supported top brand glucose meter with strip price reduced to under 10 2. 303,000 Savings** 3. All appropriate patients can test to achieve goals Monitoring Choice Typical Outcomes Fully supported top brand glucose meter with strip price reduced to under 10 1. 334,800 Savings** 2. All appropriate patients can test to achieve goals Low Risk 40 No testing No testing Diet and Exercise 10 No testing No testing High risk are those taking tablets that can lead to rapid blood glucose fluctuations and hypoglycaemia Based on an average CCG in England * ** 03
* Cost Saving Calculations OPTION 1 eduction in Cost of Prescribing R and DKA Hospitalisations Tests per day Current annual cost Achievable annual cost 931 2.0 208,008 208,008 Using Insulin 3,143 1.0 354,524 230,556 High Risk 1,746 0.5 97,504 63,409 Low Risk 4,656 0.2 104,004 Diet and Exercise 1,164 0.0 97,144 48,572 Patient Group Number Type 1 Diabetes DKA Hospitalisations* 69 186 Ketone Testing OPTION 2 7,569 2 packs pa 861,184 558,114 Cost benefit 303,069 Reduction in Prescription Costs Tests per day Current annual cost Achievable annual cost 931 2.0 208,008 135,273 Using Insulin 3,143 1.0 354,524 230,556 Tablets 1,746 0.5 97,504 63,409 Low Risk 4,656 0.2 104,004 Diet and Exercise 1,164 0.0 Patient Group Type 1 Diabetes Number 764,040 429,239 Cost benefit 334,801 Based on an average CCG in England * 04
Simple Implementation Process The Key to Reduced Hospitalisation and Vital Cost Savings STEP 1 Inform Practice Managers n Explain the opportunity and the process n Ask Practice Managers to: Write to patients, or we can arrange the mailing Change patients repeat prescriptions STEP 2 Practice Managers Inform Patients n A new top brand meter has been selected n Contact GlucoMen to receive your new meter n Your prescription will be changed n Use up current supplies before switching Patients receive their meter directly from GlucoMen n GlucoMen handle meter supply and training Pharmacists are informed to ensure adequate stock 05
Clinicians Needs Will Be Met Better Outcomes for Patients: Reduce Potentially Fatal DKA 12% of people with T1D have been 3.3% of people with T1D had DKA hospitalised with DKA in the last 5 years (just 0.5% of people with T2D)(6) in 2010 11 and the incidence is rising(7) > 220 deaths due to DKA each year 8,472 people with diabetes were and across all age groups(9) admitted in 2010-11 for DKA, at least once(7) 5 year prevalence in Type 1 diabetes hospitalised with DKA in the year of 2010(8) 6. National Diabetes Audit 2009-2010. 7. National Diabetes Audit 2010-2011. 8. National Diabetes Paediatrics Audit Report 2009-210. 9. Office for National Statistics Mortality Statistics: Deaths Registered in England and Wales (Series DR) 2010 2003-2004 2004-2005 2005-2006 2006-2007 2007-2008 2008-2009 2009-2010 2 4 6 8 10 12 14 Ketoacidosis 9% of children with diabetes were 5 year prevalence (%) 0 It is estimated that 50% of hospital admissions could be prevented with improved education and patient self-care 9. Sick day management using blood 3-hydroxybutyrate (3-OHB) compared with urine ketone monitoring reduces hospital visits in young people with T1D: a randomised clinical trial. L.M.B. Laffel, K. Wentzell, C. Loughlin, A. Tovar, K. Moltz and S. Brink. Healthcare Professional Training and Symposiums n RCN accredited DKA prevention training n Training for Primary Care and ward staff n Nationwide team of Diabetes Support Specialists Innovative Healthcare Solutions n Telemedicine: Smartphone app enables glucose diary to be emailed and viewed by clinicians 06
Patients Needs Will Be Met Top Specification Meter Features and Support n Access to appropriate testing n Education leaflets n Freephone support line n Website support and information n FOC replacement items For patients who need to test blood glucose and blood ketone n 0.3μl blood sample n 4 second test n 400 test memory Surpasses ISO 15197:2013 accuracy and haematocrit interference criteria For patients testing blood glucose only Safe, easy, accurate testing n 0.5μl blood sample n 5 second test n 730 test memory Surpasses ISO 15197:2013 accuracy and haematocrit interference criteria 07
CALL 0800 243 667 AND ASK TO SPEAK TO THE PRIMARY CARE TEAM OR EMAIL glucomen@menarinidiag.co.uk www.glucomen.co.uk Menarini Diagnostics Wharfedale Road, Winnersh, Wokingham, Berkshire RG41 5RA. Telephone: 0118 944 4100 Fax: 0118 944 4111 Email: glucomen@menarinidiag.co.uk Code GL13002 Call: 0800 243 667 Email: glucomen@menarinidiag.co.uk