*MEDICINE* GLP-1's for diabetes

[cewalters]

I have split this original codelist into 2 new codelists:

1) glp1s that are not combined with anything else; 2) glp1s that are combined with something else.

These two new codelists should: 1) not share any codes; 2) when combined, should result in the original codelist.

Any glp1 medication that is not combined with something else should be in the "non-combined" codelist; any glp1 medication that is combined with something else should be in the "combined" codelist.

[a-d-brown]

Reviewed the original codelist to check it's still correct...

Two additional GLP-1's identified in BNF code structure:

• Albiglutide - can be ignored as withdrawn from market, no longer available.
• Tirzepatide - this drug is an agonist of both GIP and GLP-1 receptors. I think it's probably still ok to class it with the pure GLP-1 agonists given that the overall effect of agonising either receptors is similar, i.e. to promote insulin secretion. Currently only 1 prescription in past 12m, but NICE are expected to issue guidance on its use in Oct23. So, it may be worth adding to the codelist now to help futureproof it.

If we do decide to add Tirzepatide to the GLP-1 codelist, then it may be worth describing the other codelist as 'GLP-1s combined with insulin', to avoid any ambiguity re. what 'something else' is.