FreeStyle Libre on NHS? Check criteria

FreeStyle Libre is an innovative device designed for diabetic patients to monitor their glucose continuously. So far, all diabetic patients who wanted to use FreeStyle Libre had to self-fund the device. From April 2019, a new agreement came into place, allowing some diabetic patients to be prescribed FreeStyle Libre on NHS. In this post, I summarise Freestyle Libre and NHS criteria that need to be fulfilled in order to get the sensor prescribed by a GP.

What is FreeStyle Libre sensor?

Freestyle libre sensor is a glucose monitoring system that automatically measures and continuously stores glucose readings. Freestyle libre sensor updates glucose levels every minute and stores up to 8 hours of glucose readings. Patients who use FreeStyle Libre are able to collect data for glucose concentration over 24 hours by scanning the sensor a minimum of three times a day with FreeStyle reader. Patients do not need to ‘finger prick’ to get their readings.Freestyle Libre sensor is worn at the back of the patient’s arm. Each sensor lasts for up to 14 days.

Patients may benefit from continuous measurement of glucose, which allows for better management of their condition with reduced finger-prick checks.

FreeStyle libre website is a great source of additional information on FreeStyle libre senor.

What is the price of FreeStyle Libre sensor?

FreeStyle Libre starting pack costs £159.95. This starter pack includes:

• FreeStyle Libre reader
• two FreeStyle Libre sensors, providing for up to one month of use

Note: Patients are able to use their Android or iOS phone to take readings. The FreeStyle LibreLink app has many features of similar functionality to the FreeStyle Libre reader.

FreeStyle Libre sensor cost:

• £57.95 including VAT (directly from Abbott website), prices may vary
• Please note that diabetic patients are eligible for VAT exemption on items such as blood glucose monitors, testing strips. Patients need to present the VAT exemption form at the time of purchase to be exempt from paying VAT. See an example of a VAT exemption form for diabetic patients. Pharmacy teams may not be aware of this. I would recommend to print VAT exemption form before visiting any pharmacy.

Where to get FreeStyle Libre sensor?

• Directly from FreeStyle libre website (currently supply restricted to existing customers)
• Online pharmacies
• High street pharmacies: multiple chain pharmacies such as Tesco Pharmacy or Lloyds have accounts open with Abbott and can order FreeStyle libre sensors for patients. These are delivered to the pharmacy directly within 2-3 working days.

FreeStyle Libre on NHS: criteria

From April 2019 some diabetic patients are able to get FreeStyle Libre on NHS. Clinical Commissioning Groups (CCGs) across the country have budgets set for FreeStyle Libre reimbursements. These represent up to 20% of England’s type 1 diabetes population.

The following patients may meet the NHS criteria for getting FreeStyle Libre prescribed by a NHS GP (NHS England, 2019):

1. Patients with type 1 diabetes or

2. Patients with any form of diabetes who are on hemodialysis and who use insulin as a treatment

Both patient groups listed above need to be classified as patients who need intensive blood glucose monitoring with more than 8 glucose checks daily, confirmed with a 3-month data review.

3. Pregnant women with type 1 diabetes – including 12 months after the delivery

4. Patients with type 1 diabetes who are unable to routinely self-check blood glucose due to disability and who require care to manage their monitoring and insulin therapy

5. Patients with type 1 diabetes who self-funded their flash glucose monitors before April 2019, who would have met one or more criteria listed above, should they be in place at that time and who have shown improvement in HbA1c since self-funding

6. Patients with type 1 diabetes who experience recurrent hypoglycaemia episodes or have impaired awareness of hypoglycaemia

Additionally FreeStyle Libre – NHS criteria require:

• Patients to educate on the use of flash glucose monitoring (in person or online)
• Patients to have regular reviews with a local clinical team
• Patients to perform no less than eight glucose level scans
• Previous or consideration of future attendance on type 1 diabetes structured education programme

FreeStyle Libre 2

Abbott has already announced that a new version of Freestyle Libre will be available to the patients (no dates confirmed yet). FreeStyle Libre 2 will use Bluetooth technology to give optional real-time warnings on hypoglycaemia (low glucose levels) or hyperglycaemia (high glucose levels).

FAQ

References:

NHS England (2019). Flash Glucose Monitoring: National Arrangements for Funding of Relevant Diabetes Patients. Available at: https://www.england.nhs.uk/2018/11/nhs-to-provide-life-changing-glucose-monitors-for-type-1-diabetes-patients/ Accessed on 18/06/2019