Variation in antidiabetic spending per diabetes patient on the GP register varies 1.7-fold across the country, according to an NHS report that urges CCGs to review any variation in antidiabetic prescribing in their area and to consider whether local practice is in line with NICE guidance.
The GPC said the diabetes data should not be used to benchmark the quality of care provided by GPs, but CCGs should use the data to drive improvements in their local area.
Diabetes prescribing costs saw their fastest rise in four years in 2014/15, soaring to 10% of the annual primary care prescribing budget at a cost of over £860m.
But data published in the Atlas for Variation 2015 suggests that spending varies across CCG areas, with spending on antidiabetic items ranging from £205 to £354 per patient on the GP diabetes register – a 1.7-fold variation.
The figures take into account insulin items, non-insulin anti-diabetic drugs and blood-glucose testing strips.
But the results show ‘there is no correlation between spending on insulin items and the percentage of people with type 1 diabetes or type 2 diabetes’.
The report instead suggests that the variation is down to ‘inefficient spending’ where ‘more expensive products are prescribed’ instead of cheaper alternatives that are just as effective.
This is leading to resources being consumed ‘in excess of those necessary to deliver treatment’, with greater use of insulin analogues over conventional insulin, new oral diabetic drugs over older drugs and unnecessary blood glucose testing in people with type 2 diabetes.
GPC clinical and prescribing subcommittee chairman Dr Andrew Green said: ‘Data such as this, showing variations in data across the country, are vital to alert commissioners to those areas of care where there are significant differences between their area and others.
‘As such, once their cause is established and understood they can be drivers for change and for improving care.
‘However, they are not in themselves markers of the quality of the care provided by individual GPs or practices, and care must be taken to understand the underlying reasons for differences between areas, and the implications of those differences. This meaningful interpretation is a far more difficult task than simply illuminating variation.’