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Publication, Part of

Prescribing for Diabetes in England 2008/09 - 2018/19

Official statistics

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Total cost of prescribing

12.5% of the total cost of prescribing in 2018/19 was for the treatment of diabetes

In 2018/19, the Net Ingredient Cost (NIC) of prescribing in primary care was £8,630 million. Of this, £1,075 million was allocated to drugs and devices used in diabetes.

This is the highest cost of any individual section in the British National Formulary (BNF).

Definition: Net Ingredient Cost (NIC)

The basic cost of a drug as used in primary care. This is the cost at list price excluding VAT, i.e. the price listed in the national Drug Tariff or in standard price lists. It is not necessarily the price the NHS paid. It does not take into account any contract prices or discounts, dispensing costs, fees or prescription charges income, so the amount the NHS paid will be different.

Definition: British National Formulary (BNF)

The British National Formulary (BNF) is a therapeutic classification structure that provides information for clinicians. It is widely used in NHS IT systems and NHS Digital official publications to allow comparisons between drug groups.

The format of the BNF was changed from Edition 70 (September 2015 - March 2016) to make it more user friendly. However, the NHS Business Services Authority (BSA), who process dispensed prescription forms and collect prescribing data, continue to use the classification structure prior to Edition 70. NHS Prescription Services, within the NHS BSA, have created pseudo BNF chapters 18 to 23 for items not included in BNF chapters 1 to 15 (mainly dressings and appliances). Further information on classifications and pseudo chapters can be found on the NHS BSA website

Prescribing for diabetes is captured in Chapter 6.1 'Drugs used in diabetes'. Further information on diabetes medications can be found in Background and scope.

Total items prescribed

5.0% of the total number of items prescribed in 2018/19 was for the treatment of diabetes

In 2018/19 the number of items prescribed in primary care was 1,099 million. Of this, 55 million items were drugs or devices used in diabetes. 

Definition: Number of items

Prescriptions are prescribed either by a paper prescription form or via an Electronic Prescription Service (EPS) message. Each single item prescribed is counted as a prescription item.

Change over time

Drugs used in diabetes are increasing in total cost and number of items over time

The NIC for drugs used in diabetes has increased from £599 million in 2008/09 to £1,075 million in 2018/19, which is an increase of 79.3%. The number of items of drugs used in diabetes has increased from 33 million in 2008/09 to 55 million in 2018/19, which is an increase of 68.0%.

This is a higher rate than that of all other prescribing in primary care, which has increased over the same time period by 5.8% for NIC and 30.6% for number of items. 

Cost of prescribing for diabetes by category

The cost of prescribing for antidiabetic drugs has increased more than for other categories of drugs used in diabetes

The NIC for antidiabetic drugs has increased from £168 million in 2008/09 to £540 million in 2018/19, which is an increase of 221.2%.

This is a higher increase than for the NIC of insulins, which has increased over the same time period by 22.5%, and the NIC of diagnostic and monitoring devices, which has increased by 26.8%.

Number of items prescribed for diabetes by category

The number of antidiabetic drug items prescribed has increased more than for other categories of drugs used in diabetes

The number of items for antidiabetic drugs has increased from 21 million in 2008/09 to 40 million in 2018/19, which is an increase of 90.2%.

This is a higher increase than for the number of insulin items, which has increased over the same time period by 35.5%, and the number of diagnostic and monitoring device items, which has increased by 20.3%.

Cost per patient

The average cost of diabetes drugs prescribed per patient with diabetes was £327.78 in 2018/19

NIC per patient on the Quality and Outcomes Framework (QOF) diabetes register varied between £208.07 and £587.12 at the CCG level. 131 CCGs were within ±10% of the National average.

Definition: Quality and Outcomes Framework (QOF)

The objective of the Quality and Outcomes Framework (QOF) is to improve the quality of care patients are given by rewarding practices for high quality care, based on a number of indicators across a range of key areas of clinical care and public health. Participation in QOF is voluntary, though participation rates are very high at 95.1% of General Practices in England.

Please note:

Cost per patient for a CCG may be affected by General Practices being excluded from the QOF diabetes register (for example, Kernow CCG). A list of those practices where validators have requested that they are excluded from the QOF figures can be found by filtering on the ‘NHS Digital Comment / Action’ column of the ‘QOF 2018-19: Practice validation comments’ file published here.

CCG data is presented using the structure correct from 1st April 2019.

CCG codes can be linked to names using the CCG data files in the Resources section on the Overview page. 



Last edited: 11 November 2019 3:52 pm