Guess what was the most-prescribed drug in the US over the last 12 months? Yup, levothyroxine ..........

so it comes as no surprise that the tenth most prescribed drug was an anti-depressant .....

medscape.com/viewarticle/82...

[Hidden]

Need to register!

[Hidden in reply to Hidden]

Sorry cinnamon_girl, I'd forgotten that, but it is free to register.

[Hidden in reply to Hidden]

Thanks Hypnoteq, will sign up.

[PR4NOW]

If you look at the second list, number 30 is 'Thyroid' and as of yet we haven't been able to get a clear understanding of just exactly what that is. Is it all the other thyroid drugs combined? Mary Shomon was going to try and get clarification so we will see what happens. The total for #1 and #30 is 27,678,639 and the US population is approximately 318,000,000 so that means about 11.5% of the population is taking thyroid meds if my math is accurate. The question of course is how many people are there that need thyroid meds and aren't getting them. Another interesting point is that Synthroid has been off patent for years and it still has dominant market position. PR

PS Registration is free and they do get some interesting articles.

[helvella Administrator in reply to PR4NOW]

I don't think that levothyroxine ever was patented in the USA? (Nor do I know if ever it was in the UK!)

Rod

[PR4NOW in reply to helvella]

I'm not sure Rod but I think they might have had a patent for awhile. Harrington in the UK was the first to synthesize T4 around 1928 or so but I can't remember the full history anymore. Even so, amazing market share for a drug without a patent. PR

[PR4NOW in reply to helvella]

Rod, doing a quick look the only thing I can find is Synthroid was introduced in the US in the 1950s. Nothing on a patent or history but I'm pretty sure a UK drug company was involved for awhile. I had or read a short history but I can find the copy. PR

[PR4NOW in reply to helvella]

Rod, finally, I knew I had this somewhere. You are right, no patent in the US. I've read a more detailed history but can't put my hands on it. The jump in sales from 2004 to current is rather amazing. PR

healthunlocked.com/thyroidu...

formularyjournal.modernmedi...

In 1958, the first synthetic T4 entered the market: Synthroid, originally manufactured by Flint Laboratories. Never receiving patent protection, Synthroid was distributed without major competition for approximately 40 years. Since its creation, the production and distribution of Synthroid has changed hands several times. By 1990, Flint Laboratories had been acquired by Boots Company, Inc. In 1995, Knoll Pharmaceuticals acquired the pharmaceutical branch of Boots and later that year, both became subsidiaries of BASF AG. Then in 2001, Abbott Laboratories acquired BASF AG and became the current distributor of Synthroid.

Synthroid was, and still is, the industry leader in terms of sales. Synthroid is the second most commonly prescribed drug in America and in 2004 had sales of $627 million.3,4 Even through FDA has listed several other drugs as bioequivalent, including Unithroid, Levo-T, Levothyroxine, and Levoxyl (Table 1),5,6 Synthroid has been able to maintain an extraordinarily high percentage of the market (82% of the market as of May 2005).3

[helvella Administrator in reply to PR4NOW]

Bearing in mind that it is really in the period since 2004 that patient groups have appeared on the internet (many were there before that date, but not by very much and with many fewer users/members). So the growth in Synthroid dominance with the huge knocking may patients have given it is all the more impressive for their marketing department.

Mind at least one major competitor have withdrawn. (Was that Levothroid?)

Rod

[helvella Administrator]

Not sure that the figures mean quite what the article appears to suggest.

Number of prescriptions is what is mentioned, but unless they are for equivalent periods, that could be very misleading. For example, our UK levothyroxine is almost universally 28 tablet blister packs. Whereas the USA products vary - Synthroid = 90, Tirosint = 28, Unithroid = 100. Also not sure what happens to the counting if you need two different dosages - for example, 100 + 25. (Mind, in the USA there are usually far more dosages available so multiple tablets seem to be less common than in the UK.)

Not in the mindset to go and find out more, but the picture may not be quite as it initially appears.

Nevertheless, the scale of use is phenomenal.

Rod

[PR4NOW in reply to helvella]

I agree, I only think we can come up with rough approximations. Here in the US a monthly script is fairly common but that is not always the case. PR

[gabkad]

As of last year in January, more prescriptions for Synthroid than any other medication were prescribed in Canada.

To me, it's shocking that the incidence of thyroid problems is so high. Why? What's going on?

In Canada, cow milk contains approximately 300 micrograms iodine per litre. A very high percentage of children up to age 19 have excess intake of iodine. Then after age 19, mostly because dairy intake falls, an increasing percentage of individuals become mildly to moderately iodine deficient until over 35% of the over age 60 group are mildly or moderately deficient.

Mild deficiency correlates to a TSH of over 3.0 and a moderate deficiency to over 5.0. (There are studies done in India with goitrous children where both urinary iodine and TSH have been measured.)

(Prior to the iodization of salt in the 1920s, 40% of school children in Toronto had visible goitres. This is the 'goitre belt'. There is also no selenium in the soil.)

Health Canada wanted to reassess the amount of iodine added to salt in around 2009 to determine if due to recommendations for lowering salt intake, is there sufficient iodine in the salt. Health Canada has not made any announcements in this regard that I have been able to find. But Statistics Canada did publish a urinary iodine study. Seems the situation is multifactorial because milk appears to provide the bulk of iodine for children. Older people not only reduce their salt but also their dairy intake. Many people are using non-iodized sea salt because they think it's 'natural'. It contains a lot of bromine.

statcan.gc.ca/pub/82-625-x/...

If this does not work or won't go through,, just google Statistics Canada Iodine status.

Possibly there is a British equivalent available?

There is a 1950s world survey of goitre. It's a huge document but available on line. I think it was done by the WHO ncbi.nlm.nih.gov/pmc/articl...