Short "use by" on Mercury Pharma Liothyronine not acceptable at £9.22 a tablet

[MacG]

I realise that I am very fortunate to have Liothyronine (T3) prescribed through the NHS, but feel that there is an issue with short "use by" with the Mercury Pharma 20mcg tablets that I am supplied with, to the extent that on some occasions I am struggling to get through the tablets before they reach the "use by".

Example: I requested a repeat prescription from my doctor on 28/4/17. A few days later I called at the pharmacy to pick up my tablets and was given tablets that have a “use by” date of 10/8/17. ( Please note that I have read previous posts on whether medication should be taken after the “use by” date and appreciate that there are various views on this.)

My point is that at £9.22 a tablet why should we have to put up with stock that is so close to its “use by”.

This has been an ongoing problem that I initially raised with the pharmacy. We agreed that rather than their system making an automatic order as soon as I pick up a prescription they would wait until I contacted them to say I had made the repeat prescription request from my doctor (thereby cutting out the problem of T3 sitting on their shelves for three months before I am even ready to collect it). The situation did to an extent improve at this point, but with regard to my most recent prescription as outlined above, I queried the date and reminded them of our arrangement and was told that what I had been given had “just come in”.

Thinking the problem was with the pharmacy, I have approached another pharmacy and explained the issue and was told that yes it does come in on a really short “use by”.

I rang Mercury Pharma this morning to try and get to the bottom of it and was told that Liothyronine tablets have a shelf life of just 12 months and was initially told that considering the time it takes tablets to go via a distributor to the pharmacy then it would have a short “use by”. I pointed out, however, that the tablets that I am being given commonly have just over three months shelf life. I was told that the stock for the 10/8/17 had now been “blocked”. (I wonder when that happened, I didn’t have the presence of mind to ask for that date, though obviously AFTER 28/4/17.) I was told that the next batch that was now available had a “use by” of 4/10/17. And thereby the problem continues……

At £9.22 a tablet this is not good service.

[Rapunzel]

This is completely shocking and dreadful to read, as I can only imagine that it makes those fortunate enough to secure T3 in the UK from the nhs even more expensive to treat - there will doubtless be T3 with such a short shelf life disposed of by pharmacies where they haven't had enough scripts for their stocks to be exhausted by the time of expiration. Unless Mercury Pharma underwrites the cost of expired meds, this sends already price gouged T3 costs spiralling ever upwards.

Much as I appreciate that most pharmacies will not have a supply until it is requested, this is another nail in the coffin for the economic efficacy of nhs T3 supplied in the UK. How can this be, when my most recently sourced Greek T3 has an expiration date of 02/2020. An inferior method of production, surely?

Thanks for raising MacG 😠

[MacG in reply to Rapunzel]

You have made some really good points here Rapunzel. Thank you for responding. I would be interested to know just how widespread this issue is with Mercury Pharma T3.

[UrsaP]

MacG I have just checked my latest packet - Exp date 05/2018. Mine are NHS Thybon Henning brand sourced by pharmacist from Germany. So obviously as Rapunzel says - Inferior production or, in my view a load of b*****s! Passing off old meds AND charging the earth - how much more criminal can this company get. Maybe you should be reporting this to the CMA are they still looking at Concordia?

[MacG in reply to UrsaP]

Hi UrsaP. Who are the CMA?

[humanbean in reply to MacG]

I think it might be these guys :

gov.uk/government/organisat...

[MacG in reply to humanbean]

Thanks for that

[UrsaP in reply to MacG]

MacG It is those guys.... Lodge a complaint... there are deciding whether to investigate Concordia re the price hikes....apparently they are making a decision in Sept. the more support for the investigation the better.

[MacG in reply to UrsaP]

Thanks for this - I was unaware of the investigation. I'll certainly put together a letter.

[MacG in reply to UrsaP]

Hi UrsaP, sorry for the slow response on this, but I was just going through the thread/making notes ready to take this forward. You mention that your NHS T3 is Thybon Henning brand (German) I was under the impression that the only brand available for NHS prespcription in the UK was Mercury Pharma. If you could shed any light on this that would be much appreciated.

[UrsaP in reply to MacG]

MacG last Oct.. .having returned to my usual gps they were struggling to get usual UK brand. Sourced from Germany. I found worked better. Think UK stuff was starting to cause headaches. Asked chemist to stick with this brand. Gp now specifies my request on prescription.

[MacG in reply to UrsaP]

Many thanks for getting back to me - much appreciated. Have also looked at some other threads now on Thybon Henning. Having done so, I realise that you can't get it without a prescription. My pharmacy STILL hasn't been able to fulfil all of the most recent prescription I put in half-way through July for the Mercury Pharma liothyronine. They have given me some tablets to be going on with but have sent back TWO lots of meds they have been sent because of the short use by. I am increasingly anxious that either my T3 will be pulled by the surgery OR there will be supply problems with Mercury Pharma. I am putting together a case for the CMA (have down-loaded a form from their website). I feel that the short use by as well as the cost is a result of the fact that there is no competition. Also the fact that they only supply 20mcg tablets when the majority of us (I would say VAST majority of us) take it is 10mcg doses. I fear I might be too late, however, bearing in mind the Sept deadline you mentioned above.

[helvella in reply to MacG]

If there is a real shortage, the MHRA can do what they did in 2013:

webarchive.nationalarchives...

If you can retrieve your prescription, or obtain a replacement, you can use it to obtain non-UK products such as Henning Thybon. Have a look at versandapo.de for one possible supplier. This is one of the most likely products for a pharmacy to supply under shortage conditions but, obviously, if you order your own, you will have to pay for it.

[MacG in reply to helvella]

Many thanks for responding. Have had a look at Versandapo.de website. 100 x 20mcg tablets €30.15, as I sure you are aware. I am nervous about rocking the boat with my GP, with whom I have a good working relationship. To date I haven't mentioned anything about the short "use by" to the surgery. "Named patient" may not be an option as, if I understand it correctly, the onus is then on the prescriber if anything goes wrong medically speaking. Would there be any other costs for the surgery beyond the €30.15? Helps to know these things.

[UrsaP in reply to helvella]

This might explain why I am still getting mine - TH brand. Chemist was having difficulty getting usual UK brand. (which I had noted was starting to give me headaches) He souped TH. I noticed headaches went so asked him to stick with TH. Might be why I'm still getting it - pure luck!

[MacG in reply to UrsaP]

I am going to call at the pharmacy later to try and get the remainder of my T3 prescription submitted about three weeks ago now. If there are still problems I will mention the Thybon Henning and see what their reaction is.

[Binkie]

The cynomel i buy in france has always had 2 year use by dates thank goodness as i do like to keep 6 month stock pile in case. The 3 month T3 prescription i got from endo in march this year (from hospital pharmacy) had use by date 20/5/17 so in fact 10 days worth were officially out of date before end may! i spoke to endo who said hospital had now prevented him prescribing it anymore and was probably old stock, however as they never have stock and usually order it in, whose old stock is it....i agree very poor practice x

[MacG in reply to Binkie]

I, like you Binkie, would like to have a bit of "slack" in the system so if there are any glitches or if my surgery decides that they can no longer fund it for me I have time to source myself. At the moment I am right up against it with the short use by.

[helvella]

Not for one moment meant to disagree...

If the prescribing of liothyronine has been curtailed by the NHS, certainly if that curtailment is greater than Mercury Pharma had anticipated, it is wholly predictable that they will not have managed to shift their stock. Hence, what they have gets older, and older. What should have been sent out a year ago is only just getting to pharmacies.

Some years ago I saw a "special" dispensed by a pharmacy. 28 capsules to use at one a day. Use by was set at 28 days after they had been made up. Took several days for them to get from specials manufacturer to pharmacy. Hence impossible to use within the time period.

Of course, in that case, they were not in a position to actually test the potency over time so just slapped 28 days on everything. But patients MUST NOT be expected to understand and to take medicines that are out of date. (If you choose to do so after doing your own researches, that is a different matter.)

[MacG in reply to helvella]

Many thanks for chipping in Helvella- more food for thought. I don't want this issue with short use by to slip under the radar. I am prepared to write a letter or two (......or three) in order to highlight the issue. Would it be the CMA as suggested above?

[helvella in reply to MacG]

I think you need to include the MHRA, the Department of Health, your local CCG, PALS, etc.

OK - so they might all ignore you, but nonetheless worth contacting everyone who might have a finger in the pie.

[MacG in reply to helvella]

Thanks for responding. Certainly will.

[UrsaP in reply to MacG]

MacG Try writing to the Chief Medical officer [e-mail] Your local 'health watch' too. MP's BBC/ITV and anyone you can think of...the more of us writing the more clear the size of the problem and the more likely we will get a response. I know people have even written to Prince Charles and others. So if you, or anyone else knows of anyone personally, celebs, journalists etc who might be able to add weight and 'publicity' try and get them involved too. People don't have to be 'sufferer's' to help. they could be friends and relations too, as the problems we all have do impact them too.

[MacG in reply to UrsaP]

Thanks for taking the time to respond UrsaP. I shall add the CMO to my list!

[Binkie in reply to MacG]

my local Mp Jon Ashworth who is shadow health minister has tried on my behalf and been ignored and fobbed off but worth emailing him as the 'shadow health minister' [e-mail] he should be looking into this scam and at least it has crossed his desk before. I have always found him very pro active if not always effective x

[Rapunzel in reply to helvella]

it is wholly predictable that they will not have managed to shift their stock. I'll let you know if there's a boot fair in Sheppey, Rod Lots of dodgy stuff ends up there...including moi on occasion 👮👮👮🚔 Nee naw nee naw

[Shelley1954]

I picked up my T3 from the pharmacy 2 weeks ago, expiry still dated 10/8/17, I am being prescribed monthly so next ones due in 2 weeks, will be interesting to see expiry date.

6 weeks ago I emailed Mercury Pharma as I was concerned that the tablets I had been given were not that effective and the label I had been given was clearly marked for another prescription. They responded saying they would investigate.... to date I have heard no more!

[MacG in reply to Shelley1954]

Thanks for this Shelley1954. I am not alone then! Bet the "use by" on your next prescription is 4/10/17!!

[Shelley1954 in reply to MacG]

MacG If it is August date I wont accept them! I assume there is no sale or return offered to pharmacies for medication, so they use the opportunity of the little brown bottle to get shot of it!

[MacG in reply to Shelley1954]

No doubt some would! When I took the out of date tablets back I was really concerned at the waste. 28 tablets at £9.22 a tablet. £258.16 down the NHS drain! The young lad who I frequently deal with on the counter seemed unphased/uninterested.

[GM50]

Interesting to see these posts. My T3 is prescribed to me loose in a small bottle with no use by date on it at all. I suppose I could be using meds totally out of date!

[MacG in reply to GM50]

My pharmacy was originally doing this, decanting them out of the original bottle and not writing the date on. Then one day they gave me the original container along with some tablets decanted. I took the decanted tablets first then went into the cupboard for the tablets in the original container. I noticed that the tablets had passed their "use by" two weeks earlier. Up until that point I had simply trusted that everything was absolutely as it should be. Never in my life have I ever been given tablets on prescription like this so close to their use by. This is what alerted me to the problem in the first place. I took them straight back to the pharmacy and since then they write the date on the bottle if they decant or increasingly just give me the original container. I always open the prescription at the counter in the pharmacy and check the dates.

I, like many of us, have had such a journey to even get the T3 in the first place...this latest issue is just another symptom of the apathy with which the mainstream medical community treat thyroid problems.

I am sorry bit I am going to have a bit of an angry vent. Here goes!

At various points since my diagnosis in 2013 the following phrase has popped into my head: "I seem to have stumbled into a scandal"

THIS FEELS SO MUCH LIKE SECOND CLASS TREATMENT. Why did I have to:

a) fight to get a diagnosis in the first place? (My life fell apart while I waited for diagnosis in what I call "my lost decade"!)

b) fight to get the right dose of levothyroxine? (My GP at that time was managing my condition solely by testing TSH and kept me on 25mcg of levo for the first 6 months.)

c) spend hours online when I realised I was going to get no further help in that department? (Thank God for Thyroid UK and this forum.)

d) research other local surgeries/GPs in the hope of finding someone/somewhere who would at least listen to my concerns and undertake more comprehensive testing.

e) change my surgery at a time when I was at a completely at the end of my tether.

f) Pay privately for the DIO2 test (which incidentally shows that I have inherited the faulty gene from both parents). Why is this test not available on the NHS?? Why are we not even told that it is available by our GPs???

g) Take the initiative and suggest to my new GP that I would like to try a T4/ T3 combo.(Boy, oh boy did I rehearse that conversation before the appointment!)

h) Be told by the pharmacy that I couldn't take the two together when I euphorically presented my new prescription!!

.....and now: Why do I have to:

a) say a little prayer every time I put in a repeat prescription request because I am afraid that the medication that has helped me get my life back will be pulled because the price of one tablet has been hiked to £9.22?

b) be absolutely scrupulous about checking the " use by" dates on those expensive tablets because I am consistently being given old stock?

Once again....."I seem to have stumbled into a scandal"

[cwill in reply to MacG]

Too many of us have a similar story and are still fighting to regain our lives. Well done for raising the issues and for finding the energy for the battle.

[Shelley1954 in reply to GM50]

GM50 Mine are loose in a brown bottle too but I ask for the batch number and expiry date which they write on the PIL that they give me with them.

[MacG in reply to Shelley1954]

Hi, just wondering what PIL is

[Shelley1954 in reply to MacG]

MacG Patient information leaflet, they should give you one of these, 1st time the leaflet I was given was someone elses prescription, obviously no longer required as bits of typed info on it were scratched out.

[MacG in reply to Shelley1954]

Thanks

[helvella in reply to MacG]

MUST give one. It is expected that the pharmacy will provide one, but if you ask it is legally required to give you one.

Further, it MUST be the one for your medicine. For example, with levothyroxine, they would not be allowed to give you a spare Actavis PIL when they had supplied Mercury Pharma.

Please demand one.

For your convenience, many are available at this official site:

medicines.org.uk/emc/

[GM50]

Now I've been alerted to this I shall so the same. Thank you

[Francis1957]

I order my Liothyronine monthly so mine always have a 3-4 month date on them I don't know how much you are ordering at a time but they don't have a long shelf life on them so it's best to order them a month's supply at a time which is what I do.

[MacG in reply to Francis1957]

Hi Francis 1957,

In one respect that's a good idea, but my surgery has set all of my prescriptions up on a 3-monthly turn around and I don't want to draw attention to wanting a different set-up because of the liothyronine. As I said in an earlier post, every time I order a repeat prescription I say a little prayer that the surgery will not pull it due to the cost. I really don't want to draw attention to any problem with it as far as my surgery is concerned. It's awful that we have to think like this isn't it.

[Chunipet]

Hadn't even thought to check the expiry date till I read your post - just presumed they would be well within date. I checked the ones I collected today from Boots and they are 10/8/2017. That's just 7 weeks away. By the time I take the last one there'll be only 2 weeks till they're out of date. I have been saying for some time that I think I need a higher dose as they don't seem as effective. Now I'm wondering if it's just because they've lost some of their potency!

[helvella in reply to Chunipet]

I'd encourage everyone to open the bag and check every item - each and every time they pick up a prescription. Check the product, dosage, expiry date, number, everything.

Of course, I'd be a hypocrite if I didn't admit that I have failed to do so on occasion - but I do try to do so before even leaving the counter.

[Bettan]

I regularly return half the tablets at Boots counter with a "Boot's owe me X jars slip" because the tablets are too close to the expire date . If Mercury Pharma claim that Liothyronine tablets have a shelf life of just 12 months then it is MORE LIKELY TO BE 10 MONTH. Ha ha i like their excuse : ".. was initially told that considering the time it takes tablets to go via a distributor to the pharmacy then it would have a short “use by date". Makes it sound as if the tablets are manufactured cheaply somewhere far away before they even reach the distributor back in uk. Yes, it is a great pity that we need to be so vigilant when we have to pick up our lifesaving medication.

[lc1973]

Hi MacG

For the short period of time i was on prescribed MercuryPharma liothyronine i also recall the short shelf life, certainly no more than 3 months to go...like you i was pleased to be prescribed it but in the back of my mind i agree with your post that it isnt good!