Pharmacist-led insulin pen prescribing review to save local NHS £44,000 annually

A pharmacist-led review of insulin pen prescribing on the Isle of Wight has led to an estimated annual saving of £44,000.

The review, commissioned by NHS Isle of Wight clinical commissioning group (CCG), assessed the cost per 100 needles and the length of needle prescribed for 6,818 patients who regularly used pre-filled and reusable insulin pens.

According to NHS England guidance, ‘Items which should not routinely be prescribed in primary care’, which was updated in June 2019, prescribers should not write new prescriptions for insulin pen needles that cost more than £5 per 100 needles, adding that patients on such prescriptions should be moved to another type.

The guidance also recommended the use of 4mm needles — rather than 8mm or 12mm — to prevent intramuscular injection of insulin. 

The CCG’s medicines optimisation team shortlisted low-cost, 4mm needles which were then tested by a sample of patients with diabetes. The preferred needles were used to update the local formulary.

Following this, pharmacists from Interface Clinical Services, an independent clinical services provider, assessed patients from 15 GP practices to identify patients who were using insulin pen needles and who could be transferred to lower-cost, 4mm insulin pens.

Before the review, 58% of patients with diabetes were using the low-cost 4mm needles. A statement issued on behalf of the review team said that, of 6,818 patients assessed, 1,750 patients had had their pen needle use reviewed and, of those, 624 patients were transitioned onto the lower-cost 4mm needle pens. Following the transition, 94% of patients with diabtees were using the 4mm needles.

David France, medicines optimisation pharmacist for NHS Isle of Wight CCG, said the review “has given us an ongoing annual saving of thousands of pounds, and ensured that our patients are using the most appropriate length needles properly and safely.”