NHS Could Save £40,000 Per Patient Annually with Tablet Medicine Switch for Children
Experts have revealed that providing children with a specific medical condition tablets instead of liquid medicine could save the National Health Service tens of thousands of pounds per patient each year. Researchers from Great Ormond Street Hospital conducted a groundbreaking study examining patients with congenital hyperinsulinism, a rare condition affecting approximately one in every 30,000 to 40,000 children.
Substantial Cost Differences Between Medication Formats
Children with congenital hyperinsulinism require treatment with diazoxide to maintain stable blood sugar levels, as the condition causes excessive insulin production in the body. Until now, this treatment has typically been administered as a liquid formulation. The financial implications are significant: liquid diazoxide costs £15.50 per 50mg, while the tablet version costs just £1.15 for the same dosage.
Experts estimate that switching from liquid to tablets could save the NHS approximately £40,000 per patient annually. This substantial saving comes from both the direct medication cost reduction and associated efficiencies in administration and storage requirements.
Successful Transition for Young Patients
The research team at Great Ormond Street Hospital conducted a pilot project involving 19 patients aged seven to thirteen years old. The primary objective was to determine whether children could successfully transition from liquid to tablet medication while maintaining stable blood glucose levels. All participants were closely monitored throughout the study period.
Remarkably, researchers found that even children as young as seven were able to successfully switch to pills, with many expressing a preference for tablets over the often unpleasant taste of liquid medicine. The hospital team is now planning to expand their research to assess whether patients as young as four years old can make the same successful transition.
Transformative Impact on Daily Life
Eleven-year-old Jess Manktelow from Kent, who has been a Great Ormond Street patient since she was fifteen months old, participated in the project. Her experience highlights the profound impact of the medication format change. Previously, her school and family life revolved around administering liquid diazoxide multiple times daily, which required specific storage conditions in glass bottles and administration via syringe.
"It has made a big difference taking medicine that doesn't taste horrible," Jess explained. "There were times where I didn't want to take it because of the taste. It makes things very easy for me now, I'm able to do it myself and it doesn't take up as much time at school or when I'm doing things I like, like climbing."
Her mother, Steph Manktelow, expressed similar enthusiasm: "We were so excited when the team told us we could switch to the diazoxide tablets. We'd been hoping for some time, we knew it was a better solution and would allow Jess to have control over her condition and that is very important."
Unexpected Quality of Life Improvements
Kate Morgan, the clinical nurse specialist at Great Ormond Street who co-led the project, noted that while researchers anticipated cost savings, the scale of quality-of-life improvements exceeded expectations. "We knew the potential this trial had for savings, but the scale of the quality-of-life improvements for children and their families we are seeing is something we didn't anticipate," she said.
Morgan emphasized that "children are so much more than their diagnoses – they have full lives and families and their illnesses affects everyone, so it is very important we do all we can to make simple, positive changes that impact everyone for the better."
New Perspectives on Patient-Centered Care
Dr. Antonia Dastamani, consultant of paediatric endocrinology and diabetes at Great Ormond Street and co-lead of the project, highlighted how the research has shifted perspectives on patient consultation. "It is common practice to ask patients how they're finding treatment, or how they feel when they have injections, but we never thought to ask patients about the taste of medicines and whether they like them," she explained.
This revelation has prompted healthcare professionals to reconsider how they involve children in treatment decisions. Dr. Dastamani added: "This has shed a light on key questions we now want to ask children and young people about their care and treatment so they can be more involved and have more independence in their lives."
The successful transition from liquid to tablet medication represents a significant advancement in both healthcare economics and patient-centered care for children with congenital hyperinsulinism, potentially serving as a model for other pediatric conditions where medication format impacts both cost and quality of life.
