LIOTHYRONINE T3 UK SHORTAGE!: I have been... - Thyroid UK

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LIOTHYRONINE T3 UK SHORTAGE!

Jaro profile image
Jaro
31 Replies

I have been prescribed T3 for two years.I have felt so well and so much better than just thyroxine . However, for the past ten days my chemist has not been able to obtain any supply and I have not had any to take for a week. If this problem continues I will be back to the same condition of feeling unwell and I would really like to avoid this. Taking more thyroxine does not help.

Can anyone help?

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Jaro
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31 Replies
Jamjaf profile image
Jamjaf

Have changed my pharmacy to boots on the advice on of Poppy03 who blogged yesterday. Will arrive in 5 days. Try your closet boots.

Rachellb profile image
Rachellb

I've just found out I can't get my prescription filled either and it's likely to be the end of June before the manufacturing problem is sorted out. I don't know how on earth I am going to be able to continue to work without any effective medication. We've all had enough to put up with trying to get well again and to convince the medical profession that T4 doesn't work for us without this latest blow, it's quite unbelievable that this could happen and no alternative :( Thanks for the advice, will try Boots.

Poppy03 profile image
Poppy03 in reply toRachellb

Ensure you tell them they need to order it via their specials department in house. It is there but it seems that few pharmacists seem to know about it.

Jaro profile image
Jaro

According to my chemist our local highstreet Boots do not have any either. However, thank you, I will telephone myself. ASDA didn't have any and confirmed my own chemist's searches. Thank you very much though.

Jaro profile image
Jaro

I can empathise with Rachelb and I am so worried . I really don't want to return to how I felt two years ago. I will also try BOOTS.

Jaro profile image
Jaro

JAMJAF

You are a star. I have got six tablets at a small village Boots!!!! So thank you.

Poppy03 profile image
Poppy03 in reply toJaro

Do you mean six pots?

Jaro profile image
Jaro in reply toPoppy03

No just six tablets! Therefore i will still have to find a supplier asap.

Poppy03 profile image
Poppy03 in reply toJaro

ok, go back to your Boots, tell them they have to call their internal specialist outsourcing department and they have it or can get hold of it with 3 days notice. Do not accept that they just do not have it. The guy on the care line had to explain it to my local Boots and they were surprised at how easy it is to get once they know how.

Jaro profile image
Jaro in reply toPoppy03

Thank you for this i will do it on Monday i.f open Tuesday at latest. So helpful., thank you, you have been great.

Poppy03 profile image
Poppy03 in reply toJaro

According to my pharmacy it is Tuesday they are open and you won't be able to get through to a specials department on a Bank holiday. If you have any trouble, PM me and I will help you.

Jaro profile image
Jaro in reply toPoppy03

Fantastic . Will let you know.

RedApple profile image
RedAppleAdministrator

The MHRA released some useful information on 22nd May

Liothyronine (Tertroxin) 20 microgram tablets - continuity of supply

mhra.gov.uk/NewsCentre/What...

If you are able to, print this document and take it to your usual pharmacist. Make sure you bring this paragraph in particular to their attention, which explains to the pharmacist what to do in order to fulfil your prescription:

-------

Provision for supply of an unlicensed product

A provision exists within UK medicines legislation for the importation and supply of an unlicensed medicine to meet the special needs of individual patients. An example of what would be considered a special need would be where there is an interruption of supply of a patient’s usual medicine, and there is no alternative UK licensed product which that patient could take instead. The use of an unlicensed medicine is on the direct personal responsibility of the prescriber, hence the prescriber needs to know from the pharmacist that an unlicensed medicine is to be supplied. It would then be the pharmacy's responsibility to obtain the product from an authorised supplier of unlicensed medicines.

If a pharmacy is having difficulty in locating an authorised supplier then we would advise that they consult the trade press where such suppliers advertise their services. Should any pharmacist still be unable to locate an importer then they can contact the MHRA imports section on 020 3080 6715.

-----------

Jaro profile image
Jaro

Thank you so much however my chemist mentioned this but my doctor won't prescribe un licensed drugs.

RedApple profile image
RedAppleAdministrator in reply toJaro

Have you actually asked your GP to temporarily agree to an unlicensed T3 medication during this crisis?

helvella profile image
helvellaAdministrator in reply toRedApple

As RedApple says!

Note that it is an unlicensed MAKE of a licensed medicine. It is not as if Liothyronine/T3 is itself unlicensed. Just that no other manufacturer (or distributor) has asked for a licence.

Rod

Jaro profile image
Jaro

Still on the search and so many people nationally in same position! Perhaps we could Get together and start a supply chain ourselves.?

Rachellb profile image
Rachellb

Thank you all for this very valuable information. I hope you get some more tablets soon Jaro. My local pharmacist at Lloyds is trying to help and has managed to find me a few days supply to be going on with. Have you tried Lloyds as well as Boots? My GP didn't know about the shortage and I expect some people have 3 months prescription at a time so hopefully aren't in the same crisis as we are.

Indigokiwi1 profile image
Indigokiwi1

Hey everyone,

I was also faced with this problem yesterday. I managed to get a Special prescription for 5mcg tablets instead of 20mcg ones, so i have to take four a day. My GP rang around and found a pharmacy to dispense them. I was getting rather poorly after three days of no tablets, so unlicensed ones dont bother me at this moment in time!

Jaro profile image
Jaro

Did you purchase privately ? My GP won't prescribe for unlicenced product.

Indigokiwi1 profile image
Indigokiwi1

No i didnt purchase it. It was on a prescription (medical exemption as usual). What dose are you on, jaro? Try asking for the 5mcg version. My bottle has "special prescription" written on it and the 5mcg tablets are huge compared to the 20mcg ones. I was given a two weeks supply as i am visiting my mum. Going to pester my regular GP now

Indigokiwi1 profile image
Indigokiwi1

Update: spoke to my regular GP and i have found a pharmacy in Stockport which has 60 T3 tablets. They are putting some aside for me

Jaro profile image
Jaro

Wow!Like gold .

Indigokiwi1 profile image
Indigokiwi1

Update: spoke to my regular GP and i have found a pharmacy in Stockport which has 60 T3 tablets. They are putting some aside for me

Indigokiwi1 profile image
Indigokiwi1

Yep its kinda like goldust at the moment! Grab what you can!

Indigokiwi1 profile image
Indigokiwi1

Update: spoke to my regular GP and i have found a pharmacy in Stockport which has 60 T3 tablets. They are putting some aside for me

Good news!

Mercury pharma confirmed today (31.05.2013) that their liothyronine tablets are already back in stock. Pharmacies can order Mercury liothyronine tables from either of 2 wholesalers: AAH and Alliance Healthcare. All pharmacies have an account with Alliance Healthcare (a proportion also use AAH). As a result, your pharmacy should be able to obtain Mercury liothyronine tablets very soon, if they haven't already.

Just to clarify a few points which have been raised...

1. The shortage of liothyronine in the UK was not caused by exporting, or quotas. Given that the UK version of liothyronine is unusually expensive, foreign pharmaceutical wholesalers would not wish to purchase UK stock. Exporting occurs only when UK branded medicines are substantially less expensive than the same brand in other EU countries. The current wholesale price of Mercury liothyronine tablets is high (net price, £52.46 per pack of 28). As far as I know, the shortage was caused by a delay in obtaining the active ingredient, resulting in a delay in tablet production.

2. Mercury pharma are able to charge a high price for their liothyronine tablets because no other manufacturer currently sells this drug in the UK; there is therefore no price competition to keep the price low. Bear in mind, however, that Mercury are not preventing other companies from launching their own liothyronine (this product is not patent protected). The Department of Health are not able to force any other manufacturers to obtain a license and start producing this product. As a result, other competing manufacturers may or may not start to sell liothyronine in the UK over the coming years. This is not something that the NHS can control.

Because liothyronine is naturally present in the body (and blood), it is difficult for companies to demonstrate that their tablets are equivalent to the reference brand (which is performed by measuring blood levels after a tablet has been taken). This may be the reason for the absence of other suppliers. Another reason could be difficulties in sourcing the active ingredient.

3. There is no reason to think that Mercury would deliberately create a shortage of liothyronine, as was suggested above, this would simply reduce sales. Due to the fact that they are the UK's sole supplier, they *already* have control over the price (which they have increased dramatically over the last few years).

4. Mercury pharma have an unusually large number of out-of-stock situations. This is by no means unique to liothyronine - far from it. I have seldom known a company to have so many out-of-stocks. It is therefore rather unfortunate in my opinion that the sole supplier of this important medicine happens to be Mercury!

5. Unlicensed liothyronine products imported from the EU are licensed products in the country where they are normally sold. There is no reason to doubt the quality of these imports, they are regulated medicines in the country of origin, it's just that they are not regulated by the UK authorities. They will contain exactly the dose of liothyronine specified on the label eg. 20mcg. The issue is that there are other ingredients in the tablets apart from the active drug. These ingredients may be slightly different between Mercury liothyronine and the European versions. This could result in a very slight difference in the amount of liothyronine which is actually absorbed from the tablet (ie. the bioavailability may be different). This is only a potential problem. I do not think it is likely to be a problem in the majority of patients. Fortunately, few patients will now need to use the imports, unless the UK product becomes unavailable once again, which is quite possible.

helvella profile image
helvellaAdministrator in reply to

Thanks for the lengthy and helpful post.

Are you in a position to comment on the Lloyds pharmacy issue where a poster said that it would take three weeks to be available because they have to use one particular supply route?

Rod

in reply tohelvella

You're welcome.

I do not work for Lloyds but I can comment.

Lloyds pharmacies order stock from AAH pharmaceuticals. AAH are one of the largest pharmaceutical wholesalers in the UK. AMCo distribute liothyronine via 2 wholesalers: AAH and Alliance. This type of restricted distribution arrangement is now common for products which have no competition. In contrast, medicines such as levothyroxine which are available from more than one manufacturer are supplied via all wholesalers.

The 3 week timeframe probably came from out of date information provided by one of AAH's customer service assistants, when the pharmacy called them to ask about availability.

AMCo confirmed to me yesterday than they now have stock of liothyronine and are supplying both AAH and Alliance. The wholesalers will have had liothyronine on back order. Lloyds should therefore be able to obtain liothyronine very soon, provided that they continue to place orders, and that liothyronine does not suddenly go out of stock again because the quantity sold into wholesalers was insufficient to meet demand. Knowing Mercury, this is more than possible!

Oh, and just to clarify one more point. If a doctor prescribes a product which is only available as an unlicensed medicine in the UK (eg. liothyronine 5mcg tabs), they do not need to mention the unlicensed nature of the product on the prescription. For example, they could simply write...

Liothyronine 5mcg tabs, Take XXX daily, 56 tabs.

On the other hand, for products which are normally available as a licensed product in the UK (eg. liothyronine 20mcg tabs), the pharmacist will/should not order an unlicensed import unless the doctor has requested it on the prescription (which they may need to do if the UK product is temporarily unavailable).

In order to permit the pharmacist to dispense the unlicensed version, and to ensure that the pharmacy can claim for correct payment, the doctor needs to write....

Liothyronine 20mcg tabs (to be dispensed as an unlicensed import) - or words to that effect. 56 tabs, or whatever quantity is required.

helvella profile image
helvellaAdministrator

Four-year-old thread - hence turning off replying.

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