This is the response I have received today, in response to my letter, questioning the current methods of diagnosis and treatment of Thyroid patients. All authorities seem to be passing the buck to me. I explained that the current tsh & free t4 tests are insufficient, when the patient is telling you that they are still experiencing symptoms.
Dear Ms ,
Thank you for your correspondence of 28 April about your diagnosis and treatment . I have been asked to reply.
I was sorry to read of your ill health and I appreciate your concerns about access to the most effective treatments.
Best practice on the identification and management of hypothyroidism has been provided in the Royal College of Physicians’ guidance ‘The diagnosis and management of primary hypothyroidism’. This document was developed on behalf of organisations such as the British Thyroid Association, British Thyroid Foundation and Society for Endocrinology, and is endorsed by the Royal College of General Practitioners.
The guidance states that overwhelming evidence supports the use of thyroxine T4 hormone replacement alone in the treatment of hypothyroidism. This is usually prescribed as levothyroxine tablets. The guidance does not recommend prescribing additional T3 hormone (liothyronine) in any presently available form. However, this does not prevent clinicians considering other forms of thyroid hormone replacement if appropriate.
In addition, NHS England is leading a review of low-value prescription items and introducing new guidance for clinical commissioning groups, with a view to substantially saving NHS expenditure in this area. This will identify areas of prescribing that are of low clinical value or are available over-the-counter, often at a lower price for minor conditions such as indigestion, travel sickness, coughs and upset stomachs.
In developing the guidance, NHS England will seek the views of patient groups, clinicians, commissioners and providers across the NHS.
Further information is available on the NHS England website at:
More generally, decisions about what medicines to prescribe are made by the doctor or healthcare professional responsible for that part of the patient’s care. Prescribers are accountable for their prescribing decisions both professionally and to their service commissioners.
With regard to medicines prices, the Department is aware that there have been a number of increases in the prices of certain medicines, including thyroid medication. These include instances where a product previously marketed as a brand has been subsequently marketed as generic and an increase in price has been applied in view of the lack of a competitive market for that product.
Any concerns about possible anti-competitive behaviour by pharmaceutical companies should always be reported to the Competition and Markets Authority. The Authority was asked to look urgently at the evidence uncovered by The Times as part of its investigations into excessive drugs pricing.
There are systems in place to ensure that the NHS obtains the best value possible from the purchasing of medicines. There are voluntary and statutory schemes in place to consider the prices of branded and generic medicines rather than consider each product individually.
The Department also has legislative provisions to allow it to intervene with regard to the prices of medicines. However, any investigation would require a high-level and detailed knowledge of the company’s business to be able to make a judgement as to whether a particular price increase was justified.
Now that Parliament has been dissolved before the General Election, the Department cannot comment further on this matter. What happens on the issue of the NHS in the future will be a matter for the incoming Government.
I am sorry I cannot be more helpful.
Ministerial Correspondence and Public Enquiries
Department of Health