Expenditure on diabetes treatments and achievement of glycaemic control: retrospective analysis

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To establish if a relationship exists between the prescribing costs of diabetes treatments and the achievement of Quality and Outcome Framework DM6 standards of glycaemic control.


A retrospective cross-sectional study of all 92 primary care organizations in the north of England comparing net ingredient cost of diabetes treatments, corrected for diabetic population, with the percentage of patients achieving HbA1c < 7.4% (Quality and Outcome Framework DM6 indicator).


The overall net ingredient cost for diabetes treatments varies from £225 to £382 per person per year. On regression analysis, expenditure on all diabetes treatments, on glitazones or on blood glucose test strips have no significant impact upon the percentage of people achieving an HbA1c < 7.4%. There is an inverse relationship between spending on analogue insulins and target achievement (r = −0.08, P = 0.001).


At primary care organization level, there is no association between weighted expenditure on diabetes treatments and achievement of glycaemic control targets. Although there are limitations to what can be inferred from analyses of this type, these data support a judicious and carefully directed approach to the use of newer, more expensive treatments until clear evidence of added benefit is forthcoming.

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