Medical device standardisation for diabetes: a 6–year evaluation of cost savings

This is a follow-up study to research published in 2017, which evaluated the effectiveness of an audit and change programme aiming to improve the cost-effectiveness of self-monitoring of blood glucose prescribing in two Greater Manchester clinical commissioning groups. The present study aimed to assess the longevity of the changes achieved over a 6-year period, comparing clinical commissioning groups that adopted the change programme in 2015 with those that adopted it later or not at all in Greater Manchester. Prescribing data for Greater Manchester were extracted from a publicly available database and categorised into three groups: clinical commissioning groups that adopted a medicines optimisation programme in 2015, those that adopted it later and those that did not adopt the programme. The savings of each clinical commissioning group were balanced using diabetes prevalence data and compared against an average clinical commissioning group in England. Data were compared using Kruskal Wallis tests, post-hoc Dunn's tests, Mann-Whitney U tests and linear regression. Clinical commissioning groups that implemented the change programme in 2015 had greater savings than those that did not implement the change programme (P=0.0036). The former group also saw greater percentage reductions in mean self-monitoring of blood glucose unit costs than the NHS England average (29.6% vs 20.3%; P<0.001) between the fourth quarter of 2014 and the fourth quarter of 2020. A structured change programme that aims to standardise prescribing can lead to substantial cost savings over a time period of 6 years.