A new study by Boots UK and the University of East Anglia demonstrates that community pharmacies are well placed to screen patients for type 2 diabetes in England, which could significantly decrease the cost of the service and resources to the NHS.
More than three million people in the UK were diagnosed with diabetes in 2014 and there was an estimated 590,000 people with undiagnosed diabetes.[1] The estimated cost of type 2 diabetes to the NHS in 2011 was £8.8bn and, between then and 2035/36, the cost of diabetes to the NHS is expected to increase from 10% to 17% - with one third of this being due to complications of the disease.[2]
Early identification and treatment of diabetes is known to reduce the incidence of complications. Screening services increase the number of diabetes diagnoses and results in cases being identified 3.3 years earlier on average.[3]
The study, which looked at the cost-effectiveness of community pharmacy based type 2 diabetes screening, found that the cost per test and identification rates in patients were similar to those reported through medical practices for type 2 diabetes. Efficiency of the screening service was also improved through the use of a risk screening tool questionnaire, which reduced the number of tests needed.
Researchers also believe that, by locating a community pharmacy type 2 diabetes screening service in areas of suspected greater diabetes prevalence, and increasing the proportion of patients who follow pharmacist advice to attend their medical practice, would significantly improve the cost-effectiveness of the service.
Marc Donovan, Chief Pharmacist at Boots UK, said “This research highlights that there is a real opportunity for pharmacies in the UK to offer community based type 2 diabetes screenings and continue to support the services offered in GP practices.
“Not only does screening support patients by increasing early identification and treatment of type 2 diabetes, it is also known to reduce the incidence of complications, have a positive impact on costs to the NHS and, ultimately, supports the government’s public health agenda.”
David Wright, Professor of Pharmacy Practice at University of East Anglia, added “Unsurprisingly, the study shows that screening though community pharmacies is no more costly or less effective than undertaken through other routes. For such services to be cost-effective however, we also need to intervene in those identified as ‘high risk’ to prevent progression to diabetes.
“This is a natural addition to the diabetes screening process and, with appropriate funding, is something which community pharmacists can effectively do to contribute to the public health agenda.”
The paper, titled Diabetes screening through community pharmacies in the UK: is it cost-effective, was published in Pharmacy through MDPI and is available to read here: https://www.mdpi.com/2226-4787/7/1/30/pdf
[1] Diabetes UK. Diabetes: Facts and stats. May 2015 2015. https://www.mrc.ac.uk/documents/pdf/diabetes-uk-facts-and-stats-june-2015/ (accessed 14/08/2017 2017).
[2] Hex N, Bartlett C, Wright D, Taylor M, Varley D. Estimating the current and future costs of Type 1 and Type 2 diabetes in the UK, including direct health costs and indirect societal and productivity costs. Diabetic Medicine 2012; 29(7): 855-62.
[3] Rahman M, Simmons RK, Hennings SH, Wareham NJ, Griffin SJ. How much does screening bring forward the diagnosis of type 2 diabetes and reduce complications? Twelve year follow-up of the Ely cohort. Diabetologia 2012; 55(6): 1651-9.