NHS Review of "low value" Medicines including T3

More bad news for those who are taking liothyronine.

Even though the British Thyroid Association new guidelines are saying patients should be able to stay on T3 if it helps them the

NHS are saying that it is a "low value" medicine.

There is an option for comments at the bottom of the piece so do please let them know what you think!

bbc.co.uk/news/health-39413915

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26 Replies

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  • A shocking and negligent decision for thousands of patients. 🤕🤕🤕🤕🤕

  • It's not decided yet. They still have to consult. Although I know consultations are rubbish when you are objecting. I will write to everyone I can think of on this one.

  • Have sent an e-mail :-(

  • Done.

  • I have replied to the BBC item I hope in a suitably coldly logical manner. In short, the scandal of monopoly-driven sky-high prices for T3 coming from ineptitude in procuring and utter complacency in not actively looking for new suppliers at lower cost as in Europe. Not only that but the wrongheaded approach to treatment control and the arrogance of the NHS assertion that "the vast majority of patients do well on T4". Hello the minuscule minority of 10% + who don't.

  • I live in Sweden where we pay the actual cost of medication up to a maximum of around £200 a year, after that everything is free for the rest of the year. Last August my gp prescribed Liothyronin to add to Levaxin. When I went to collect the medication the pharmacist was most apologetic about the high cost of Liothyronin, and she couldn't understand why I started to laugh. I told her what was happening in the UK and the cost of it there, then she understood why I was quite happy to around £20 for 100 tablets. Takeda is the manufacturer of my Liothyronin and I've just googled it, they are the largest pharmaceutical company in Japan & Asia, but they also have a branch in Sweden. So there is no excuse for the NHS to pay such extortionate prices for drugs all they need to do is shop around.

  • In practical terms, that works out not too different to our prepayment certificate. But prepayment only makes sense if you know, or are fairly sure, that you will have more than 13 prescriptions in the year ahead.

  • Is it pure chance that this slips into public the day before the brexit is triggered?

    Of course, no-one was trying to bury this news, no not at all.

  • Don't worry helvella , trust us to resurrect it!

  • The NHS and its squadron of "we know best" pen-pushers need to get their finger out and deal with the outrageous price gouging by the manufacturer.

    I'm almost convinced (with my little tin-foil hat on) that they ignore this fact so that they have a magnificent excuse to stop prescribing T3 and couple with scare tactics that will freak out (what they think of as) idiot patients. In plain sight and all that...........grrrrrr.

  • They are also dragging their feet over an investigation jnto Concordia and the price gouging of liothyronine

  • Another article and comments section in which to vent:

    theguardian.com/society/201...

  • Let's, for the sake of argument, call that £31million pounds spent on Liothyronine... That, at £258.20 per pot of 28x20mcg tablets, amounts to a staggering 120,062 prescriptions a year! (who gets all of these???) Anyway, were the NHS to source these from Greece where you can buy 30x25mcg tablets all nicely sealed in blister packs for less than €2 (but for the sake of this calculation we'll call it €2!) this would reduce that bill to just €240,124, which converts to just £208,808.73!!! That would be a massive saving of £30.7million!!! So now who is responsible for this waste of money??? And if this is being done to Liothyronine, how many more of these examples can be found across the whole drugs supply spectrum? Go figure... 😡

  • It's £1 for 30 25mcg. One pharmacist I saw was in stitches that the NHS pays €3 a tablet.

  • We can do a reasonable calculation from these numbers. If on average someone is using 1 20 mcg tablet T3/day then the 120000 odd prescriptions allow us to work out what fraction of patients with thyroid problems get T3. Firstly the prescriptions only last for one month (rounding up 28 days) so in patient terms only 10000 patients get a years supply. We can estimate say 2% of the population have thyroid problems - around 1.5 million. Now 10000/1.5 million is 0.7% of patients. But 10-15% of patients should on average need some T3 supplementation. This just shows the gross shortfall in correct prescribing.

  • However, some of us (me included) take 2x20mcg tablets of T3/day and I know of some people here who take a lot more than that...

  • Hi Zephyrbear. Do I need a prescription in Greece, I heard that one could just buy it over the counter, is this true?

  • That is true. My brother lives there and he gets it for me and sends it over.

  • Wow. Thank you so much for the reply. Do you think I could go over in person and make some arrangement to pay by credit card by phone in the future? It's a big ask but maybe your brother could ask for me ? I realise this could take some time but I would be willing to travel (while I can) I can't think of any other way to stay reasonably mobile.

  • You could always travel and get your own supply. They are also available online. Post the question and you'll find plenty of information but it has to be done by private message.

  • Of course we have to exclude all those who do not go the NHS route in treatment, so the 10000 estimate is a maximum for that group. I would think only a minority of patients go their own way.

  • Anyone seen NHS England's reporting of this issue?

    (This makes it clear that the proposal at present applies only to England. Who knows what the Wales, Scotland and Northern Ireland bodies are doing or thinking?)

    NHS England to issue new guidance on low value prescription items

    28 March 2017

    NHS England will be leading a review of low value prescription items from April 2017 and introducing new guidance for Clinical Commissioning Groups (CCGs), with a view to substantially saving NHS expenditure in this area. It follows extensive work by NHS Clinical Commissioners which identified significant areas where potential savings can be made, up to potentially £400m per year.

    They have requested that NHS England now set out a national approach that would, following consultation, be adopted by individual CCGs across England. The review will seek to address the growing concern over the justification for many low value prescriptions which absorb millions of NHS funding every year, that could be spent on care which has a bigger impact on improving outcomes for patients.

    NHS England will work with clinicians and clinical commissioning groups to develop guidelines initially around a set of 10 medicines which are ineffective, unnecessary, inappropriate for prescription on the NHS, or indeed unsafe, and that together cost the NHS £128m per year. In developing the guidance, the views of patient groups, clinicians, commissioners and providers across the NHS will be sought.

    In light of the financial challenges faced by the NHS, further work will consider other medicines which are of relatively low clinical value or priority or are readily available ‘over the counter’ and in some instances, at far lower cost, such as treatment for coughs and colds, antihistamines, indigestion and heartburn medication and suncream. Guidance will support CCGs in making decisions locally about what is prescribed on the NHS.

    Careful consideration will also be given to ensure that particular groups of people are not disproportionately affected, and that principles of best practice clinical prescribing are followed.

    An NHS England spokesperson: “New guidelines will advise CCGs on the commissioning of medicines generally assessed as low priority and will provide support to clinical commissioning groups, prescribers and dispensers. The increasing demand for prescriptions for medication that can be bought over the counter at relatively low cost, often for self-limiting or minor conditions, underlines the need for all healthcare professionals to work even closer with patients to ensure the best possible value from NHS resources, whilst eliminating wastage and improving patient outcomes.

    england.nhs.uk/2017/03/guid...

    British Thyroid Foundation's reporting of it is spooky. I'm sure it must be there somewhere, but darned if I can find a single word. :-(

    btf-thyroid.org/

  • Whilst I fully agree with the withdrawal of prescriptions for medication that is readily available over the counter, Liothyronine is not one of them. Taking my T3 away from me would most certainly not improve my patient outcome - indeed, it would have a catastrophic effect on my health and probably set me on the road to not wanting to live anymore... and I'm sure I'm not the only one that feels like this. They are literally playing fast and loose with people's lives, especially when they could wipe £30.7million off that bill instantly if they would only have the bloody sense to go shopping around for the best deal instead of being taken to the cleaners by greedy pharmaceutical companies that enjoy a monopoly!

  • Removal of my T3 will have a catastrophic effect on my health and I know I would not want to live any more. Do they care????

  • There is no sense in why the NHS places no value on T3, It has certainly increased my quality of life ten fold.

    They should look at spending in other areas where money is wasted. For example, my neighbour has on autistic child. She has to go to a special school about 60 miles away.She is not capable of learning anything as she is severely disabled so in essence it is an expensive baby sitting service. The cost of travel alone is £80,000 per year as she has to have a private taxi and two people are required to be present, one driver and one helper to stop her attacking the driver.The cost of the school is £90,000 per year, so overall it costs the state £ 170,000 per year just to look after her. Yet they will not spend money on a drug which actually helps you function and potentially enables you to work and pay taxes.

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