Surfing with Diabetes – by Helen May
I’ve been surfing recently. No, this is not another of my post about the effect on my blood control of another extreme sport. This time I have just been surfing from the comfort of my sofa. On the internet.
I started with the recent news that diabetes accounts for 10% of the NHS budget. Through some Googling, I discovered that more than £1 billion is spent on diabetes drugs . Unfortunately, I could not find out what is covered by this definition of “drugs” so I decided to make the assumption this includes insulin, metformin, insulin pumps, test strips and the like.
Because I was in the mood for more Googling, I decided to investigate the contentious issue about test strips. As is commonly reported (including the latest issue of Balance), GPs keep restricting the number of test strips they will prescribe despite the counter logic when it comes to managing diabetes and the DVLA’s advice to “need to test within 30 minutes before the 1st journey and every 2 hours while driving.”
Taking one of the test strips I use (for no reason other than I am familiar with them), One Touch Ultra test strips cost £28 for 50 strips from Boots. Surely the NHS do not pay this much? I went back to my surfing and was very pleased to find the NHS drug tariff for 2013. Within this, I found that the NHS pay only £15 for the same pack. Nice to see they they have managed to negotiate a bulk discount.
But this still works out at 30p for each test which at an average of 4 tests a day every day of the year, that’s £440. In my opinion, I think that’s a worthwhile expense if it will reduce the chance of someone with diabetes ending up in hospital through complications and incurring fair greater costs to the NHS. However, with 3 million people in the UK diagnosed with diabetes, that would result in over £13 million spent on test strip each year. Is over one percent of the diabetes drug budget worth spending on test strips alone? This does sound like a large percentage when you consider the rest of the drugs that need to be paid for.
So my next surfing trip took me into the realms of “How do test strips work?” to try to work out whether they are really worth this much and whether someone (perhaps the NHS) could manufacture them cheaper. This took longer to find: there are many sites that tell you how to prick your finger and place a spot of blood on a strip, followed by beep beep and you have a reading. Eventually, I found an article explaining the science behind the beep beep. After the initial patriotic pride that the idea came from some engineers at Cranfield University in the UK. I set about understanding what these strips (and their meters) do. Whilst I trained as an Electronic Engineer, I am a bit rusty in that area now and when combined with a bit of biology, I needed to simplify the theory. but basically, this is what I understand:
• the strips suck up the blood
• the blood oxidises
• a voltage is passed over the oxidises blood
• the amount of blood glucose in the blood is related to the current over a set time
So if I was to manufacture some test strips, I would need to include a reservoir of a specific size to store the blood; I would need the ability to determine when this reservoir is full; I would need to include at least two electrodes to carrier the charge; I would need to manufacture it out of a material that was not sensitive to temperature; I would need to be able to detect differences in the make-up the blood (such as more red blood cells); and I would need to make them small and light. These strips are definitely more complex than a thin piece of plastic or the lancets (which, in case you are interested, the NHS pays just under 4p each).
I was starting to feel I was getting the limit of what I could discover online (and wondering how much I could trust 100%). I was pleased with my discovery that the NHS pays less than I would for my test strips. But I still think they are very expensive. And, despite the complexities, I feel it must be possible to manufacture them cheaper so it would not be necessary to limit prescriptions and overall save the NHS money spent on the complications of diabetes. Instead of reducing their costs by limiting test strip prescriptions, isn’t there the option to reduce the cost of each test strip? Anyone want to sent up a charity to manufacture cheap test strips?