Row as UK split over inhaled insulin
A new row has erupted over inhaled insulin after Scotland rejected its use, in contrast to provisional guidance for England and Wales, writes Gareth Iacobucci.
The Scottish Medicines Consortium reopened furious debate over the provision of Pfizer's Exubera after ruling that the 'economic case had not been demonstrated'.
NICE guidance for England and Wales is due in December, but its provisional guidance would make inhaled insulin available for needle-phobic patients – up to a third of the total – after assessment by a psychiatrist or psychologist.
GPs have condemned the Scottish decision, insisting a common system should be in place for the whole of the UK – and suggesting Scottish patients might flood across the border for treatment.
Dr John Rankin, a GP in Stirling, Forth Valley, said: 'I don't think they've given this a chance to see whether it is going to be of benefit. If it was available south of the border, that would raise a hue and cry.'
Dr Peter Fellows, chair of the GPC prescribing subcommittee, said he was unimpressed with the Scottish decision. 'Blanket bans are ridiculous. I'm worried by the increasing involvement of managers in what should be clinical matters. What we hoped for was for sensible guidance for the whole UK. That simply isn't happening.'
Despite unease at the decision, many GPs remain unsure of inhaled insulin's cost-
Dr Martin Hadley-Brown, chair of the Primary Care Diabetes Society, said: 'I don't think inhaled insulin is going to be an optimum way of delivering
insulin for many people.'