1. Blood Glucose Test Strips
CCG VALUE FOR MONEY 2
PART 1

2. Review of formulary Blood Glucose Testing Strip (BGTS) prescribing
AIM:
REVIEW OF APPROPRIATE USAGE AND NON-FORMULARY TEST STRIPS
Monitored by:
Compliance with the formulary on epact.
Target:
50% Contour Next & CareSens N as a % of all BGTS
A reduction in NIC/Diabetic Patient

3. ELMMB BGTS Guidance
Gold Standard for Blood Glucose Testing: HbA1c remains the test of choice.
Self-monitoring of blood glucose is necessary with insulin, or treatments with high risk of hypoglycaemia
A regimen should be agreed with the patient and must include the frequency and be recorded in their written management plan.

4. ELMMB FORMULARY Adults only
CareSens N 1st line choice for the following patient groups
Type 2 diabetic Metformin + Sulphonylurea
Type 2 diabetic Sulphonylurea alone
Type 2 diabetic Sulphonylurea + Glitazone or DPP4
Type 2 diabetic on GLP1,
Type 2 diabetic Triple therapy
Contour Next – as an option alongside CareSens N in the following patient groups:
Type 1 or 2 diabetics on insulin alone
Type 1 or 2 diabetics on insulin + oral therapy
Gestational Diabetes
Those under the care of a secondary care/intermediate care specialist e.g. renal

6. BGTS cost per diabetic patient on QoF Register

7. Actions:
Carry out a computer search for all patients currently receiving BGTS on repeat prescription (exclude paediatrics).
First consider the appropriateness of the BGTS prescription in line with local and NICE guidance.
If the BGTS prescription is appropriate – is the formulary meter/strips being prescribed?
All patients prescribed non-formulary BGTS should be reviewed and switched to one of the formulary choice products.
Remember to change lancets to CareSens Lancets 0.31mm/30g, pack of 100. These are a universal fit.
Add to directions on prescription the frequency of testing

8. CCG VALUE FOR MONEY 2 PART 2
Insulin Pen Needles
CCG VALUE FOR MONEY 2
PART 2

9. Review of formulary Insulin Pen Needles prescribing
AIM:
Review Of Appropriate Usage And Non-formulary Pen Needles
Monitored by:
Compliance with the formulary on epact.
Target:
90% Formulary Insulin Pen Needles as a % of all Universal Fit Insulin pen Needles

10. Current Position
1. Total spend on insulin pen needles has increased significantly recently with the introduction of safety needles design to minimise sharp injuries in carers and healthcare professionals. The introduction of various new entrants to the universal fit pen needles market provides an opportunity to offset the recent cost growth. 2. East Lancashire CCG spent £273,404 on all Insulin Pen needles for the 12 months to Oct 2013 compared to £250,927 for the previous 12 months. This represents a growth of 9.0% (£22,476). Enhanced growth is expected as the safety needles market saturates. 3 There are currently a large number of products being prescribed due to the range of needle lengths, gauges and brands.

11. ELMMB FORMULARY
GREEN - Universal fit insulin pen needles GlucoRX finepoint, Insupen, Omnican Fine

12. Actions:
Carry out a computer search for all patients currently prescribed non formulary universal fit pen needles.
All patients on non-formulary pen needles should be reviewed and switched to one of the formulary choice products:
Consider “Using needles of shorter length and smaller diameter” as recommended in Diabetes Care In The UK: The First UK Injection Technique Recommendations OR
Consider a simple same to same switch