Introduction Insulin analogues have become increasingly popular despite their greater cost compared with human insulin. The aim of this study was to calculate the incremental cost to the National Health Service (NHS) of prescribing analogue insulin preparations instead of their human insulin alternatives.
Methods Open-source data from the four UK prescription pricing agencies from 2000 to 2009 were analysed. Cost was adjusted for inflation and reported in UK pounds at 2010 prices.
Results Over the 10-year period, the NHS spent a total of £2732 million on insulin. The total annual cost increased from £156 million to £359 million, an increase of 130%. The annual cost of analogue insulin increased from £18.2 million (12% of total insulin cost) to £305 million (85% of total insulin cost), whereas the cost of human insulin decreased from £131 million (84% of total insulin cost) to £51 million (14% of total insulin cost). If it is assumed that all patients using insulin analogues could have received human insulin instead, the overall incremental cost of analogue insulin was £625 million.
Conclusion Given the high marginal cost of analogue insulin, adherence to prescribing guidelines recommending the preferential use of human insulin would have resulted in considerable financial savings over the period.
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Correction notice The “To cite: …” information and running footer in this article have been updated with the correct volume number (volume 1).
To cite: Holden SE, Poole CD, Morgan CL, et al. Evaluation of the incremental cost to the National Health Service of prescribing analogue insulin. BMJ Open 2011;1:e000258. doi:10.1136/bmjopen-2011-000258
Funding This research received no specific grant from any funding agency in the public, commercial or not-for-profit sectors.
Competing interests CP has received payment for lectures from Novo Nordisk; CP, CC and CM have carried out consultancy work for pharmaceutical companies that manufacture insulin.
Contributors CP conceived and designed the study, CM and SH collated and analysed the data, CC, CP and SH interpreted the data, SH drafted the article and all authors were involved in the revision of the article. CC approved the final version to be published and is overall guarantor.
Provenance and peer review Commissioned by the BMJ and Channel 4 News; externally peer reviewed.
Data sharing statement All data used in this study were obtained from the four UK prescription pricing agencies and are open–source.
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