Pumps and Technology
FreeStyle Libre Update
Marc Atkin led on the production of a paper on behalf of the collaborative in response to the announcement that the device would be on the NHS drug tariff from 1 November, 2017. The recommendations (selected patients with T1 Diabetes) have subsequently been used by the Regional Medicines Optimisation Committees (RMOC) in England to advise, but not mandate, Area Prescribing Committees. It seems that a ‘post code lottery’ cannot be avoided in the short term but there are encouraging signs that FSL is being made available across the UK. Northern Ireland was an early adopter, Greater Manchester, Cumbria, Merseyside, Humberside, Hampshire and Brighton have all 'gone green', although the East Midlands remains black at the time
of writing. In Scotland the decision is devolved to each of the 12 Health Boards, and decisions are pending. Wales has put in a national application. A funding agreement is not the only challenge; starting a large number of people on FSL is a practical challenge for specialist teams. The collaborative will look for ways to support teams in this.
Continuous Glucose Monitoring
The availability of this technology featured in the NICE T1 Guideline is generally poor. NW London is a notable exception. It cannot be the case that funding for CGM is currently covered by the NHS tariff in England. Individual funding requests have had a low success rate. The collaborative will be prioritising access to CGM for 2018, and will be represented on an expert group being convened. ACDC is making an application for paediatric diabetes at a national level. It is not clear what the best strategic approach is to obtain funding, so for the time being any attempt to make a case for inclusion in the national tariff as a high cost therapy, as has been suggested, is premature.
The ABCD IPN-UK has been very productive. Apart from annual conferences linked with the ABCD spring meeting – diary date 23 May 2018 in Glasgow, a number of local educational events have been staged and well-received. Two guidelines will be published early in 2018 to support pump teams – one on clinical care, the other on what a high quality pump service looks like. Emma Wilmot will present at our session at DUKPC.
Animas and Diasend
The decision by Animas to leave the pump market has meant that pump teams using Diasend free of charge as part of the package are facing the unexpected cost pressure of a licence for Diasend.
The interest in technologies other than insulin pumps has led to a rebranding of the network soon to be known as 'ABCD Diabetes Technology Network-UK' or DTN-UK for short.