Thousands of women are missing out on a vital thyroid drug after 60-fold rise in price by makers using loophole to charge NHS £7million a month
- By ‘debranding’ liothyronine its makers exploited a loophole to inflate the price
- It increased from about £4.50 to £258 in 2016 and its use has fallen accordingly
- The price increase by Advanz Pharma is being investigated by the Competition and Markets Authority and is the subject of a parliamentary enquiry
Thousands of women are missing out on a vital thyroid drug because health boards have stopped prescribing it following a 60-fold increase in price, according to researchers.
The NHS cost of a 28-day course of liothyronine – used to treat an underactive thyroid or hypothyroidism – rocketed from less than £4.50 to £258.19 in 2016, after its maker used a loophole to inflate the price.
By ‘debranding’ the drug in 2007, the manufacturer was able to avoid NHS rules which stop companies increasing the price of medicines.
A study, published today in the journal Lancet Diabetes and Endocrinology, shows that since the price hike, use of the drug has fallen significantly, with patients in the poorest areas now almost 50 times less likely to get it than those in more affluent parts of the country.
The NHS cost of a 28-day course of liothyronine – used to treat an underactive thyroid or hypothyroidism – rocketed from less than £4.50 to £258.19 in 2016, after its maker used a loophole to inflate the price
The study analysed the number and cost of liothyronine prescriptions between August 2013 and July 2018 using data from NHS England. Roughly 13,000 people – most of them middle-aged women – used to get the drug, but researchers found the average number of monthly prescriptions in each of the 195 clinical commissioning groups fell from 22 to 17 over this period.
Study leader Dr Peter Taylor, of Cardiff University, said: ‘The most substantial changes in prescribing occurred in early 2016, coincident with substantial rise in costs.’
The study found that the total monthly cost of liothyronine prescriptions in August 2013 was £758,975, but this increased almost ten times to £7,018,679 by 2018 despite the decline in use.
‘Over the period analysed, no major study or guideline has advocated a change in liothyronine prescribing,’ wrote Dr Taylor in a letter to the journal. ‘This substantial reduction in prescribing seems to have been largely driven by cost.’
Lorraine Williams, director of The Thyroid Trust, said: ‘The fact that people in poorer areas are least likely to get the treatment is disgraceful. There should be equality in the NHS.’
By ‘debranding’ the drug in 2007, the manufacturer was able to avoid NHS rules which stop companies increasing the price of medicines
Around 3 per cent of the population suffer from an underactive thyroid, which can cause depression, tiredness and weight gain. Women over 40 are at greatest risk.
The most common drug for the condition is levothyroxine. However, symptoms persist for around 10 per cent of people on this drug. For these patients, taking liothyronine may help.
The huge increase in the NHS cost of liothyronine, made by Advanz Pharma formerly known as Concordia, is being investigated by the Competition and Markets Authority. There is also a parliamentary enquiry into the issue.
A spokesman for the CMA said: ‘We currently allege that Concordia abused its dominant position to overcharge the NHS by millions for this essential thyroid drug. We are currently deciding whether the law has in fact been broken.’
A spokesman for Advanz Pharma said the company ‘invests significant amounts’ in older medicines.
He added: ‘The Department of Health has the power to intervene and set the price of any unbranded generic medicine where it feels the NHS is not getting value for money. In the case of our liothyronine, this power has never been exercised.’