Cost Of Liothyronine ....Is It Really That Expensive?

I saw my GP last week to update him with my latest medication changes

prescribed by my Endocrinologist ( as paperwork takes ages to come back from the hospital)

When he made a note of my newly prescribed T3( Mercury Pharma Liothyronine

20 mcgs ) he told me that the cost was £100 for 28 tablets!!

I was beginning to feel like a liability.

I remarked to him that maybe that's why nobody wants to do the T3 test and also may be it's not good that Mercury Pharma are the only licensed pharmaceutical company in the UK supplying it......There was no reply.

However,I can happily report that I was able to collect my next two month's supply from our pharmacy so I am fortunate and grateful to have the opportunity to try T3,but if this is the current cost of it in 2014 surely something needs to be done?

65 Replies

  • Yes T3 is dramatically more than T4. When I was fighting my GP for it a friend in the pharmaceutical industry checked out the cost in MIMS plus chemists often tell me how expensive it is to buy in ie reminding me to pick it up if they order it in for me lol! Partly I guess the differential is because T4 is cheap due to the fact that it was created decades ago so all development costs have been absorbed over the years.

  • Levothyroxine was first synthesised in 1927 and liothyronine in 1953 (at least, the papers were published in those years). So a mere 26 years apart – and even for liothyronine it was 61 years ago (from 2014).

    Liothyronine in the UK, when sold as the branded product Tertroxin, was somewhere around £15 to 20 before Goldshield/Mercury Pharma decided to sell it as a generic a few years ago. That was around ten or so times the cost of levothyroxine on a tablet-for-tablet basis at the time. It is since then that the price has rocketed.

    There are, so I have read, controls on the prices that pharmaceutical companies can charge the NHS for branded medicines. The idea being that a company should not be allowed to dictate a price when they are in control of the product. Typically such branded products are within patent so there cannot be any competition.

    In the case of liothyronine, it certainly raises suspicions that Goldshield/MP changed the product from being branded to generic solely in order to avoid such controls. There is no competition so they can charge a much higher price. They are, of course, open to competition from another company offering liothyronine onto the UK market but given the small size of the market, and the large costs of so doing (i.e. gaining a license), they probably feel pretty safe that is not going to happen. Even if it happened, they might still have a nice little earner as a competitor will not want to sell at a bargain basement price, just sufficiently less costly to gain their target market share.

    I 1927 Biochem J. 1927;21(1):169-83.

    Chemistry of Thyroxine: Constitution and Synthesis of Thyroxine.

    Harington CR1, Barger G.

    Biochem J. 1953 Mar;53(4):645-50.

    3:5:3' -triiodothyronine. 1. Isolation from thyroid gland and synthesis.



  • It is an interesting point that you make about the small market Rod.

    Surely,when we know the number of patients there are who don't even get the chance to try T3, who might do very well on it,then surely if the price came down there may be more chance of the labs doing the FT3 test when first requested and a lot more people being properly medicated a lot sooner.

    Just think about all the people who have to send out abroad in order to get it who wouldn't need to do that.......just a thought.

  • A mere 5443 prescriptions in England in December 2013.

    At the 'old' price of around £20, and the above number of prescriptions, that would give a market in England of around £1.3 million a year. Cost of license = many tens of thousands. Cost of marketing = many more tens of thousands. Cost of manufacture and distribution - I have no idea, but lets throw in some more tens of thousands. Best hope? 50% of market? So, maybe, £750,000 turnover after investment of a lot of money and no guarantee of success in gaining a license or market share.

    I'd be surprised if there are not at the very least several hundred here who buy their own from abroad.

    I still think that for some medicines a European angle might end up being the most likely - eventually. If, for example, Sanofi (who have their own product as well as own Henning) were able to say "We have products licensed in France and Germany - therefore they can be sold in the UK" it might be a lot easier for them to enter the market here.

  • I like what you are saying in your last paragraph Rod. Have there been any moves to try to initiate this? I'm a bit naive when it comes to the bigger picture and am wondering how do we work toward that goal ? What route needs to be taken to achieve it......or may be there is already work going on in that direction?

  • I only pick up odds and ends - so take everything I post with a huge pinch of salt. But there has been some work towards European licensing. With the "big" countries (France, Germany, UK and maybe some others), it would probably sail through. But the idea that every other country in the EU would have to accept a license issued by, say, Latvia or Slovenia is a problem. Nothing at all against such countries, but they don't have the resources to cope and could be more susceptible to undue pressure from such as the biggest pharmaceutical companies.


  • I can understand what you're saying Rod.Perhaps this might be a development for the future though.....something good to come out of Europe for the benefit of us all no matter who we are or what country we live in.

    I just happened to have a call late last night from my cousin in New Zealand,asking how things were going? She emigrated when she was married with 2 young children who are now 50 and 47.

    As she pointed out....the health system in NZ is very different to UK.

    They pay for everything.

    Both she and her husband have long term medication prescribed by their GP and are well on it......where does it come from? ....Germany!!

  • Have you seen this about levothyroxine in New Zealand!


  • Have just sat down to try to absorb the link you gave this morning about NZ Eltroxin and have to say I'm not absorbing it very well......obviously a bit late in the day for my thyroid brain!!

    However,I do remember that when I was first prescribed Goldshield Eltroxin (some years back,in the days of my starter dose) which as we know was " branded," that I remember reading some reviews from NZ and there were people who were having problems with it.

    I have to say that my cousin and husband happily don't have thyroid problems.I do know that one of them is using an alternative to Walfarin which doesn't have the side effects of walfarin,which is from Germany and is happy with it.

    It would be interesting to know what thyroid meds they use in NZ now and who supplies it.

  • No - the Eltroxin in NZ is NOT Goldshield/Mercury Pharma.

    It used to be made by GSK in north America. Manufacture was transferred to Germany and the recipe was changed. Then the problems started.

    Finally, the rest-of-the-world rights to Eltroxin were sold by GSK to the South African company Aspen. (However, tat did not affect UK and Ireland Eltroxin at all. Different recipe. Different manufacturer.)

    At the time, NZ had only the one levothyroxine product GSK (later Aspen) Eltroxin.

    During the crisis they had Oroxine from Australia, Synthroid from the USA and even UK Eltroxin temporarily available. Yes - that is two products called Eltroxin with different recipes from different companies.

    No wonder it was confusing! :-)


  • Hi Rod.....thanks for that.Yes it was confusing.

    I have just been looking at New Zealand Thyroid Support.

    One thing I picked up on which spoke to me....was part way down the page about acacia powder,saying that Actavis didn't contain it.

    They referred to the fact that Acacia Powder can cause Asthma in some people.

    I was reminded of how many people here have complained of breathlessness when using the current Mercury Pharma included,which I now refuse to have.However, it is also an ingredient in MP Liothyronene and that too is worrying as I am now using that and it is the only T3 option for patients via the NHS ,as far as I know.I have experienced breathlessness since being on it...that and the same muscular problems.I can see that I will soon be taking the kind advice from others here and buying something in from abroad.

  • For a disorder which is handled as if the medics know all about it and have a nice simple treatment which works for everyone, it doesn't half get complicated - and very quickly. :-)


  • Too true!........however we will keep going....Have a good week .

  • It is very cheap to buy different brands yourself, but for some reason the NHS are in a situation where they buy from just one supplier at a ridiculous price.

  • You can buy levothyroxine here without a previous prescription (the online consultation is easy)

  • Nhs will never keep costs down if only one supplier to do business with...In the real world that would never happen..there's no Competition so no need for competitive prices ..It al makes me so angry

  • Quite right Lola. I have found the purchasing system to be the biggest problem i face at work. It's a disgrace :-(

  • Thanks for your replies....I knew it was expensive,but didn't realise it was that high a price.

    At the moment,I'm halving the pill using 10mcgs a day.....can't anticipate what will be said if my Endo suggests increasing it.I have noticed that some people are taking much bigger doses.

    My progress for the week was getting caught in a huge traffic snarl up on our major motorway roundabout, I thought about an alternative route to where I was going,if I got the chance to move.After a lorry was asked to move on to the slipway to create a space to release some vehicles on to the motorway I decided I could go that way too.

    I drove down the M25 for the first time in years......just to the next junction, without butterflies in my stomach.

    I can't tell you how that felt,after having been on the T3 my Endo supplied for just over 2 weeks.( added to the increased dose of Levo I've taken since being better informed by TUK and Health Unlocked during this last year)

    It is worth the just have to keep believing.X

  • Yes, keep believing. It's so lovely when you realise you can do things you couldn't do before :)

  • As a midlander the M25 gives me the heebiejeebies as well so well done on your progress :-)

  • Well done! I've just cleared out my pantry and feel so proud of myself as I've barely moved since Christmas :-)

  • Well done you too!! If you're like me I bet you found things you forgot you had and also threw away the out of date things like spices that you bought to try a recipe and haven't used since.Now you have lots of space to fill it all up again !

    I just spent two hours in the garden clearing out the cold frame of cuttings that didn't make it through the winter and stood admiring the ones that did.Now my potting area is all clean and weeded and ready for the new season.I had birds singing from the shrubs for company and though sad that I have dead headed the last of the daffodils,a carpet of forget me nots and tulips have taken over so all is right with the world. We are two happy people.

    So pleased you felt well enough to tackle a chore and felt good afterwards....that's thyroid progress .....long may it continue.

  • Yes there were lots of things I'd forgotten about :-D

    So glad you're having a good day too x

  • When the endo suggested he prescribe t3 for me, my gp had a big splutter about the cost and said he couldn't guarantee he'd continue to prescribe, so I continued to buy it from my usual source. For £100 I could buy a year's supply and who needs the hassle from the gp?

    At my last gp appt I saw a locum who saw the t3 script on my records and wrote me a script for three months' worth. I feel bad getting them to pick up the tab knowing what they'll pay for it, but she wrote it on the same paper as my levo script so I think the pharmacy will insist on giving me both.

  • Don't feel bad about it PB, I'm sure you've paid for lots of other things yourself that you should have had. Just pick it up, it might never happen again :-)

  • Yeah, I thought that but I have plenty in already and they may just as easily use it as a stick to beat me with, so I refused. I can't stockpile it or it will go off, and I'm toying with the idea of trying ndt soon.

    As you say I have paid for a lot of stuff out of my own pocket, but all the vitamins I've ever needed probably don't add up to £600! :-)

  • The pharmacy cannot do that. Imagine if you were paying for them - many people cannot afford all the prescribed items so have make choices, often inside the pharmacy. (Simply that you are entitled to 'free' prescriptions should not change that at all.)

    Of course, what you cannot do is get the prescription partly dispensed by one pharmacy and partly at another, or at a later time.


  • They did say something about keeping it by for a month, but that would still entail ordering it, so I would be committed.

    I'm reluctant to become reliant on my gp for these meds they're so unhappy to give me, so I think I will continue to keep track of my own supply for now. I've already had a conversation with a very cross gp about it and what's the point of having them write a script, and going back to get the next not knowing if they'll refuse? It's a bit too Sword of Damocles for me!

  • It's all an area of uncertainty isn't it? I must admit I was shocked at the cost to the NHS.

    If I could source it from elsewhere at a cheaper price I would give it a try .Would you mind giving giving me a PM to tell me? I'll understand if you don't.

    I do get concerned that if I do private medicating it will affect my position with my surgery.Does that happen? I do still need a GP as not all things are thyroid related.Fortunately I am being supplied at the moment,but I too wonder how long that will last..however,will try not to cross bridges before they arrive, must just enjoy the improvements on T3 as they happen.

    I've developed fingernails like I've never experienced before.....had to cut them as I couldn't get used to them ...they felt like talons!!

    Confidence is improving too.Still have a way to go with Muscle Aches but will give it time.Have a good weekend.X

  • I think it can affect things with the surgery, but you don't necessarily have to tell them ;-)

  • My pharmacist told me it was £20 for each 20mcg of T3.

  • I reading you right? That would be £560 for 28 x 20mcgs ?

    Is that what you are on?

    I felt a bit special at £3 a tablet and I'm still not 100% certain about it.

    I'm still looking at some of the fillers being the same as in MP Levothyroxine but some are different. I'm trying to convince my self that at this price it has to be a superior standard,plus the fact that as I have stated that certain things are vastly improved for me which is great but the muscles are still struggling...... Could that be down to the fillers or may be I will need more? ......we shall see later.I know that the muscles got worse each time my Medication was increased.

    This whole situation is ridiculous.We do need some other licensed suppliers in UK don't we? What can we do?

  • He must have made a mistake, I feel sure. I don't think GP would have issued a prescript.

  • According to the BNF the cost was £68.20 for 28 tablets. I just googled it. The post granted, was from 2013 but a slight difference from other figures quoted.

  • Hi, this thread is 3 years old. The following is from a post 1 year ago but I believe it is now even higher.

    The cost, I believe has risen even more since this was posted. The following was the price 8 months ago and believe it's even higher at present because there has been dismay and I shall try although it will be difficult.

    "Thanks Josie but have just found it on internet - £152.18 for 28 x 20mcg!"

    This statement is the latest and is dated a month ago:

    Mercury Pharma currently charge the NHS :

    For 28 tablets of Liothyronine 20mcg = £256.20.

    100 tablets = £922.44

    In my own case, I need 40mcg daily, thus costing the NHS over £512 every 4 weeks.

    This is the thread and the reason the member contacted her GP.

  • Thank you shaws for confirming - I am (was) on 20 mcg per day. Which will cost according to the above amount £3,330.60p per year on 13 prescriptions. The endo wants me to reduce that to 10 mcg per day - as it only comes in 20 mcg size, it is going to be very difficult to cut in half lol ;)

  • I have used a cutter recommended by pharmacist and it works quite well. If you search above, one of our members had a Times Journalist to report on the extortionate price.

    Other members have used a safety razor blade!

  • I think I have one of those cutter pill boxes somewhere. If not try the safety razor blade :)

  • Look on Amazon for a scalpel. They are surprisingly cheap. A single blade lasts for months. I think they would be easier and safer to handle than a razor blade.

    Another possibility is a hobby knife - but don't get one with lots of funny shaped blades. Or possibly a Stanley knife, but it must be a delicate one, not one for cutting tough stuff.

  • This subject was raised at the Scottish Parliament Petition discussions.

  • I may be out of date, but I thought there were laws against monopolies and unfair trading. Surely the vast cost of T3 comes under that heading.

    Looking at it from another point of view - if T3 is so expensive it should be cheaper for your GP to prescribe dessicated thyroid and you'd probably feel better on it.

  • Is it correct that the 5mcg size tablet is even more expensive, I haven't dared ask for this but it would make my life much easier

  • I'm not aware of a 5 mcg tablet of T3 being available here in UK.

  • I was prescribed the 5mcg tablet about 3 years ago. The pharmacist grumbled about the cost as they had to get it from the US. It was made by Paddock Laboratories.

    I found that it suited me better than the UK version.

  • I just want to say thank you to everyone who has contributed to this T3 discussion over the weekend.It has been both interesting and thought provoking.X

  • No doubt hundreds of millions of pounds could be saved by the NHS if they implemented a well set up procurement function that controlled things like minimum numbers of suppliers for each drug / hormone (say 3x absolute minimum as that's the minimum number of quotes other Government departments need to go to the market and get for many things) and then procurement could be handled centrally in bulk and suppliers would have to competitively bid for those orders.

    For reference, I've found 100x 25mcg T3 can be had for less than £15 delivered from Turkey or Mexico (Tiromel made by Abdi Ibrahim or Cynomel made by Grossman respectively).

    That said, why on earth are my GP surgery paying £hundreds for the 5mcg Paddock Labs (U.S. Import my GP seemed happy to prescribe and their connected Pharmacy happy to source, comes in a bottle of 100) T3 I'm on?? Part of it is to do with the (daft IMO) low dosing - myself being prescribed only 10mcg T3 daily, which I dose 5mcg morning and 5mcg afternoon on top of 125mcg T4. It'd be easier and more cost effective to lower T4 more such that a minimum 25mcg T3 daily could be prescribed.

    I'm now dosing Tiromel 25mcg morning and afternoon, with dropping my Levothyroxine to 100mcg at the same time. I was apprehensive about increasing T3 so much but have had no adverse reaction so far (4x days in) and am monitoring heart rate and temperature several times daily - both have which have risen to more reasonable levels as both were remaining chronically low on my Endo established regime. It's beginning to indicate I have Thyroid hormone resistance but that's going off-topic.

  • There is absolutely no doubt about that! I see it every day, when I am well enough to be at work that is, but the lack of will is mind boggling!

  • It's a complete and utter disgrace, especially when you consider the fact that, when they had the ridiculous shortages last year, I managed to get my brother living in Greece to get some 25mcg tablets (pack of 30 made by Unipharm) at just under a couple of euros per pack without a prescription! He got me nearly 6 months supply for less than 20 euros! So who is getting ripped off and who are suffering on the T4 sh*t only because of it???

  • That's amazing. Hopefully it has helped you regain your health without any side effects from it? This whole issue is becoming more and more ridiculous isn't it?

  • Went down to 50mcg T4 and up to 75mcg T3 (50mcg AM, 25mcg PM) yesterday :)

    Within 3 1/2 hours my body temp was up from a basal 36.2 degC to 37.0 degC and stayed there 'til I went to bed when it dipped to 36.9 degC. All measured on a Braun Thermoscan Ear Thermometer.

    Resting heart rate also increased from 48 to 76 in the same period and I've had what feels like a warm inner glow since - even my toes feel warm.

    My basal temp this morning was 36.8 degC, resting heart rate 56 and I've taken my 2nd lot of the new dosing - just need to keep an eye out I don't overshoot and make myself hyper, in which case I'll need to lower one of the T3 doses.

  • Always good to hear of someone's improvement ...well done and I'm pleased for you.

    Is your T3 NHS prescribed Mercury Pharma Liothyronine?

    How are you coping with taking a higher dose of T3 than you are T4 Levo? Also is the NHS happily funding your quite large T3 prescription? I would be happy to hear from you.Anyway,good luck....I hope your progress continues.

  • Hi marfit,

    I'm prescribed 125mcg Levothyroxine (have been getting supplied Actavis 100mcg and 25mcg) T4 + 10mcg Liothyronine T3 (was given Paddock Labs as 5mcg as above, which I was taking one of AM and PM).

    I'm now taking 50mcg Levo and 75mcg Turkish Tiromel branded T3 (50mcg AM, 25mcg PM).

    I'm still feeling good but it's only day 2 on this increased T3 dosing, so I'm monitoring my stats carefully - I seem to be maintaining a body temp of 37.0 degC (Braun Thermoscan Ear Thermometer)

    and a resting heart rate of 76bpm.

    I had contemplated going T3 only but think I'm going to stick with some T4 for two reasons:

    1. I've read a bunch of stuff on the evils and benefits of Reverse-T3 and the most convincing argument for me about it is that it's the body's way of inactivating some T3 for certain reasons such as illness or an over-stimulated metabolism etc. That's a good safety net IMO given the high doses of T3 I'm trying to kick-start my metabolism.

    2. If ever I'm stuck without access to my T3 for whatever reason, at least there will be some T4 in my blood which my body can hopefully convert into T3 and keep me out of trouble 'til I can get some T3 again. This is also a safety-net argument.

    N.B. This regime won't be for everyone. Many, I've read, cannot even tolerate the 10mcg T3 I was taking previously. I seem to tolerate the higher doses well and I'm seeing some positive signs so I think I have Thyroid hormone resistance. Also, I've read a few places that Men can tolerate higher doses of T3 than Women - I'm the former.



  • Thanks for your seem to have thought your programme through very well and I wish you all the best for the future.

  • I don't think you can get reverse T3 from liothyronine, as I believe rT3 is produced when metabolising from T4. If you are taking enough T3 the body can 'bank' it in the Liver, I understand, and metabolise it out if not needed. The times I thought I'd 'overdosed' on T3 were, I think now, a reaction to topping up from a hypo state, i.e. all the receptors were open as there wasn't enough to go round. I'm TT, and take 60mcg on waking and 20mcg at bed. I don't feel any 'rush' taking 60 in one go, because I've got enough in my system already. I've only been doing it this way for a couple of weeks, but so far it's been way better than any previous regime, and I really recommend it!

  • Hi mick,

    Good to read of someone else on a similar dose and regime - that's great it's working well for you.

    I still have my Thyroid, it's just been under Auto-Immune attack for years. I have had dodgy pains in my neck at times and 3x instances of Tonsilitis in the last 3x years, but my Endo never placed any importance on doing any scans etc. and chose just to palpate and do TPO bloods to confirm my diagnosis, on top of the usual bloods.

    To be clear on my point around T3 and RT3, I wasn't implying that the body could convert T3 to RT3 - I was stating it as one of the reasons to keep taking a small dose of T4, as it is that which the body can convert to RT3 to allow it to in effect 'cancel out' some of the T3 in my system if necessary.



  • I wrote to my Primary Care people about this cost over a year ago but received no reply. I recently bought100 25 mcg tablets of T3 as backup; it was shipped from Mexico and cost me just over £20 inc.P&P - totally legal. Someone somewhere is ripping off the NHS - and all of us by definition.

  • It certainly seems so.I'm not totally confident about sending to Mexico for my medication,though many do.I think I'm maybe hesitant of not knowing what's in them. However,something I'll maybe discuss with my Endo if I'm not happy with my present prescription as it's the only one via the NHS.

  • I'm on both T3 and T4, I've had a real battle to get my GP to prescribe it (he flatly refused for the first 6 months) and I was having to get the prescriptions via my endo and the hospital. It wasn't until I got a prescription at the chemist that the pharmacist told me that 100 x 5mcg Liothyronine tablets cost £700 which probably explained why my GP didn't want to prescribe it! They don't manufacture the small dose in the UK so it has to be imported from either the US or Canada, hence the cost.

  • Unfortunately the USA has some of the highest prices for liothyronine and the UK's sole supplier of licensed product seems to be chasing their prices.

    Price of a 5mcg tablet from the USA seems to be similar to the cost of a 25mcg tablet so obviously not an ingredient cost!


  • I would imagine most of that £700 goes on shipping it across!

  • Considering that you could buy your own 100 * 5 microgram Cytomel for USD 150, or "generic" (e.g. Sigma, Mylan, Paddock) for less than USD 120, it does make you wonder where the rest of the money goes, doesn't it?

    Offer to buy your own and take half the price difference as a backhander... :-)

    At that price you could very nearly fly there, buy it and fly back - with a night or two in a hotel. Get two pots and you definitely could. (You cannot buy liothyronine in the USA without a prescription so not actually a viable approach.)


  • I've been, what I can only call accosted, by a pharmacy assistant on two recent occasions over the cost of my T3!

    The last time she approached me in conspiratorial fashion gripping my bag of meds in her little hand and before handing them over whispered "Do you know how much these cost?"

    I said, yes and she again whispered "They're £800!"

    I just said "I'm told there isn't an alternative"

    My husband said I should have told her they were priceless as they saved my life!

  • It's not fair for a doctor or pharmacist to guilt you for accepting a medication that can makes the difference between keeping you ill and you actually being able to have a life.

  • Tell me about it!!

  • Liothyronine sodium 20 mcg is £26.15 for a 28 pack from Goldshield.

You may also like...