price difference between T3 and T4

As most of you know, T3 is much more expensive than T4. To compare the two, here are average prices from pharmacies near where I live, for both T3 and T4 made by Pfizer/King.

Cytomel 25mcg 100 $189.82

Levoxyl 25mcg 100 $31.76

That is a factor of ~6 difference. Does anyone know if the diff is due to liothyronine synthesis really being more difficult/expensive, high cost of low-volume manufacturing, or just BigPharma greed?

32 Replies

  • Eddie,

    It is BigPharma greed but also poor negotiating skills of the national health (or whoever oversees these prices//contracts).

    There is no competitor as Mercury Pharma are the only UK licensed company for T3 so are charging what they please.

    Many members buy their own from abroad as the national health service struggles with these costs and it isn't often prescribed.


    (Edited out sentence re generic/branded pricing due to discreptioncy- 27.01.2016)


    Disclaimer: I am not a medical professional and this information is not intended to be a substitute for medical guidance from your own doctor. Please check with your personal physician before applying any of these suggestions.


  • As Flower007 says, it is a monopoly so no competition means high prices. I have an nhs script but for various reasons at one time used to buy off-script from abroad at a fraction of the price.

    I am cross that my gp tried to shame me back onto levo because I'm costing the surgery too much (for something they insist I don't need) when the fault really lies with the nhs wasting taxpayers' money.

  • When the GP tries to shame you, do you ever tell it that it cannot prove what it is trying to prove, without an FT3 test?

  • Lol, my ft3 has always been v good, so what they say makes perfect sense, but even when my numbers were great (top of range) I felt awful on levo alone. I was constipated, bloated and balding, but symptoms are subjective so I haven't got much of an argument. (The dwindling amount of hair in my hairbrush and the relative size of my ankles on levo vs combination are all the evidence I need to satisfy my own opinion that a small amount of t3 helps me a lot.)

  • Of course, symptom relief always takes precedence over lab testing (except in NHS :) ). Perhaps if your doctor had tested FT3, however, it would have found that you require an above-range FT3 and/or lower TSH, to feel well.

  • My ft3 was good, top of range, also good t4 and tsh under 1 once I was on 'enough' levo. So everything looked peachy.

    I think as the nhs is run on taxpayers' money it's thought to be prudent to base everything on scientific certainty and there's no proof that t3 will alleviate symptoms, so my gp didn't want to use it, but to their credit they did prescribe after they found out I'd been on it for some time.

  • So did the GP find any difference in lab tests, before and after adding T3, that supported your report of feeling better?

  • What sort of test are you thinking of? My antibodies remained the same, all other stuff was more or less unaffected (though my results do fluctuate a lot and I often need to change dose). Without doing the maths I suspect I'm on a lower total dose of meds than I was when on levo alone. That's as a result of my results showing me to be overmedicated (over the range) a number of times. Am I using the meds more efficiently or is my thyroid sputtering into life occasionally? Or is it just the nature of t3 that it is used more efficiently anyway? Idk. :-) Layperson here.

  • Mainly wondering if adding in T3 caused a significant drop in TSH, or significant increase in FT3.

  • Well I guess it would if you were taking more than the equivalent of the previous levo dose - does that make sense? - but I was already on a v good, 'effective' dose of levo which kept my t3 and t4 in the higher part of the range and my tsh under 1 already. For me it wasn't a matter of making my numbers look better on t3; they already looked ideal. My doctor said 'With these results you should be skinny and full of energy' and I was fat and exhausted. Within a few months on t3 I was running 3 miles 2X per day.

  • Is there any reliable proof that T4 will alleviate symptoms?

    It may work for 4 out of 5 people, but for 1 out of 5 it doesn't work as a sole medication.

    Doctors can't ask for proof for the efficacy of T3, when they don't care about the efficacy of T4.

  • Most of today's docs dose solely by numbers. They aren't interested in symptomology.

  • Ha! I didn't even catch that your figures are in USD. So much for my amazing powers of observation. :-)

  • I'd expect a difference given the smaller market, perhaps two or three times the cost of levothyroxine. However, you are very fortunate in the USA (I assume) as in the UK the cost of 28 tablets (28 not 100) is £198.62. Enter "liothyronine mims" in Google and look at the tablet cost on the first hit (for some reason this gets around the need to sign in). Just in case you have problems getting into the MIMS website here is the information:-

    Price: 20 microgram tab, 28=£198.62.

    The pharmaceutical companies are ripping us off and our UK Government is too lazy to do anything.

  • PS. I had t3 prescribed when I was in the US a few years ago and my script (3 mos) cost about $100 Eddie83. Trying to remember the dose (I thought they were 25mcg tabs). Do you know if the price is rising? That is potentially not good news for a lot of people.

  • The prices I posted are the average of various pharmacies' cash prices near me. I haven't followed the price of T3 on a regular basis. I do know that the last price I pad for Cytomel 25mcg was about $1.76 per tablet, from a pharmacy drug plan. I've always used Cytomel because King/Pfizer used to be the only company that guaranteed their T3 to be GF. Now, there is at least one other option (Perrigo T3, manufacturer claims it is GF) I could pursue, but my pharmacy plan might not be willing to carry that specific brand of generic liothyronine.

  • US public/private health care and UK private health care are going to coalesce somewhere in the middle before long.

  • Not sure "coalescence" is the right word. "Black hole" seems more like what I'm thinking of. :(

  • Well I do understand where you're coming from but if I need heart surgery or something similarly serious and expensive I'm not potentially looking down the black hole of personal bankruptcy. Horses for courses.

    The insurance companies, which have had a free ride for many many years, have a lot to answer for.

  • Re Triyotex ... could you PM me if you know of an internet source, without prescrip, for Triyotex?

  • Is this the sustained-release one? Or is it supposed to be the same as Grossman t3?

  • I knew it came in 75mcg (which for most people is inconvenient as you say). I wonder why it doesn't work as well.

  • Which T3 has gluten?

  • Nobody knows for sure. Some companies guarantee that their T3 is gluten-free. Some companies won't say that theirs is, because they don't know all that much about the source of their ingredients, and/or they don't do testing.

  • Dear Rowan-1,

    Would it be possible to PM me with your source of Gluten Free T3 please, I currently get mine fro pm Greece but don't think it is Gluten Free, it is by Uni Pharma.

  • I use Uni Pharma and it is gluten free as far as I know. It's from Greece too, so it's probably the same supplier as yours since I don't know for any other there.

  • I don't know what to say, I found that in Germany(for exmpl.) the liothyronine pharmacy cost is around 30eur for 100tabs(20mcg) product by Henning.

  • Significantly lower! 30 euros =~ 32 USD. I just paid 159 USD for 90 tabs of Cytomel 25mcg.

  • Both around the same price in France 30 tabs cynomel 25mcg 3.01 euros

    30 tabs levothyrox 150 mcg 2.63 euros

  • I currently get my T3 from Greece but would be really grateful if someone could PM with a Gluten Free source for T3 please.

    Many thanks in advance.

  • I specifically asked the Greek web source for Uni-Pharma T3 if it is GF. They told me it is.

  • This is nuts. A friend of mine bought some Levothyroxine in Turkey (Eurythrox) and brought back about 10 packets of 50 tablets (mostly 50mcg but some 25mcg) for £5.

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