Counting the cost

Prescribing analogue insulin, rather than human insulin, is an expensive option for the NHS. A recent study suggests that, between 2000 and 2009, this was something like £625 million. NICE guidelines recommend human insulin as the first choice of therapy, however. An interesting study in Social Science and Medicine looks at how NHS managers evaluate exceptional requests for high-cost drugs, based on the work of a Welsh individual patient commissioning panel.