Switching from liquid medicines to tablets improves lives and reduces healthcare costs

Switching children and young people from liquid medicines to tablets can significantly improve quality of life while also reducing healthcare costs.

Many children are prescribed liquid medicines even though evidence shows that most children aged four and over can safely learn how to swallow tablets. A new project at Great Ormond Street Hospital (GOSH) has shown that switching suitable patients from liquid medicine to tablets can lead to substantial savings. For some medicines, the change could save up to £40,000 per patient per year.

The Endocrinology team at GOSH, led by Clinical Nurse Specialist Kate Morgan and Dr Antonia Dastamani, Consultant in Paediatric Endocrinology and Diabetes, identified 19 patients who could benefit from changing the formulation of one of their medicines. All of the patients have Congenital Hyperinsulinism (CHI), a rare condition that affects around one in every 30,000 to 40,000 children worldwide.

CHI causes the body to produce too much insulin, which can lead to dangerously low blood glucose levels. To manage the condition, children often need to take diazoxide several times a day. Until recently, this medicine was usually given in liquid form.

As part of the project, all 19 patients, each aged seven or older, were switched from liquid diazoxide to tablets. The tablets provide the same therapeutic benefit as the liquid medication. Patients were closely monitored throughout the process to ensure their blood glucose levels remained stable, and families were asked about how the change affected daily life.

In addition to being easier to take and better tasting for patients, the tablets are significantly less expensive. Diazoxide tablets cost £1.15 per 50mg, compared with more than £15.50 per 50mg for the liquid formulation. This difference results in an estimated saving of around £40,000 per patient per year.

Jess’s story

Jess, 11, was one of the children who took part in the project. She has been a patient at GOSH since she was 15 months old and has taken liquid diazoxide for most of her life.

The liquid medication had to be stored in a glass bottle and measured using a syringe for each dose. Because Jess needed several doses each day, her family often had to organise daily activities around her medication schedule. This affected school routines, family trips, and holidays.

Jess lives with her parents, Steph and Tom, her two younger sisters, Pippa and Lucy, and the family dog, Dave. The whole family is involved in Scouts, with both parents working as scout leaders. When attending camps, Jess always had to take her medication with her and ensure it was stored correctly at room temperature.

Jess said, “I would always get a lot of questions about my medication when I went camping or when we were travelling through airports. It was often difficult to explain why I needed it so frequently, especially as it is not an easy condition to explain.”

In April 2025, Jess was told by her consultant, Dr Dastamani, and nurse, Kate Morgan, that she could try switching to diazoxide tablets.

Steph said, “We were so excited when the team told us Jess could switch to tablets. We had hoped for this for some time because we knew it would give Jess more control over her condition, which is very important.”

Jess now prepares her medication herself, with her parents checking the dose. The change has given her greater independence and confidence in managing her condition.

Jess said, “It has made a big difference taking medicine that does not taste horrible. There were times when I really did not want to take it because of the taste. Now it is much easier. I can take it myself and it does not take up as much time at school or when I am doing things I enjoy, like climbing. That makes me happy.”

Positive outcomes for patients and families

Since the project began in early 2025, all 19 patients have permanently switched to tablet form. There have been no negative impacts on blood glucose control. The team is now exploring whether younger patients could also be supported to move to tablets, which would extend the benefits to more families and further reduce costs.

Kate Morgan said, “We expected some cost savings, but we did not anticipate the scale of the improvements in quality of life we would see for children and their families. Children are not defined by their diagnoses. Simple changes like this can make a real difference to everyday life.”

Dr Antonia Dastamani added, “We routinely ask children how they feel about treatments such as injections, but we had not considered asking about the taste of medicines or how the format affects their daily lives. This project has highlighted the importance of listening to children and involving them more in decisions about their care.”

The project used a multidisciplinary approach, with support from GOSH play specialists and psychologists. Together, they developed learning materials to help children who found swallowing tablets challenging.

Switching from liquid medicines to tablets also supports GOSH’s Green Plan by reducing packaging and waste associated with liquid formulations. The team is now reviewing other medicines to identify further opportunities for safe and effective formulation changes.