Thyroid UK
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Prescriptions for cheaper T3 on the NHS

I'm getting bogged down in paperwork concerning T3, but before my next endo appointment, I'm need to establish clearly that NHS doctors are allowed to prescribe drugs that are not listed in the NHS formulary. For example, could they choose to prescribe Sandoz liothyronine? I believe that a post was written maybe 7 or 8 months ago by someone who gets this in Edinburgh.

Now that I know that it's not up to the CCG to decide what a doctor can or cannot prescribe, I'm going to have another push to get T3 on the NHS. It would be helpful if there is an official document that explains what doctors can do (without bowing to their local CCG).

So far both my endo and my GP have simply said that they are not allowed to do this, even though I explained about the Edinburgh example, and I gave them written instructions about how to do it. I'm starting to loose the will to live - and have the biggest pile of research papers so far to take to my endo, but nothing seems to help!!!

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The post about getting other brands of T3 can be found here :

healthunlocked.com/thyroidu...

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Thanks for the link. I previously got all the instructions from Lintably so that I could tell my endo and GP how to do it, but they still just said they couldn't do it, except on a private prescription

I'm wondering if there is guidance for NHS doctors that tells them they can prescribe things like Sandoz liothyronine that are not on the dormulary list.

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Yes, that is helpful. Thank you!!! It seems that there are multiple reasons why they can actually prescribe an affordable brand of T3. I'd better print out the guidance for prescribing on a named patient basis ......

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I've just found something useful here: bnssgformulary.nhs.uk/Forma...

Now I need to find something like this for My local CCG!

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One of the more dispiriting realisations is that the UK authorities that dole out guidelines and instructions not to treat are completely impervious to anything other than the "rules" that have been written down. Never mind that the actuality completely rubbishes those "rules", there they will stay and be obeyed until someone decides to change (without of course admitting any mistakes having been made). I'll just quote a paragraph from a "political" rather than scientific paper we are trying to get published in the UK:

It appears that what we are witnessing constitutes an unprecedented historic change in the diagnostics and treatment of thyroid disease, driven by over-reliance on a single laboratory parameter TSH and supported by persuasive guidelines (). This has resulted in a mass experiment in disease definition and a massive swing of the pendulum from a fear of drug-induced thyrotoxicosis to the new actuality of unresolved hypothyroidism. All of this has occurred in a relatively short period of time without any epidemiological monitoring of the situation. Evidence has become ephemeral and many recommendations lag behind the changing demographic patterns addressing issues that are no longer of high priority as the pendulum has already moved in the opposite direction. In a rapidly changing medical environment, guidelines have emerged as a novel though often-promoted driver of unprecedented influence and change. Treatment choices no longer rest primarily on the personal interaction between patient and doctor but have become a mass commodity, based on the increasing use of guidelines not as advisory but obligatory for result interpretation and subsequent treatment. Contrary to all proclaimed efforts towards a more personalised medicine, this has become a regulated consumer mass market as with many other situations. However, with the increased level of patient awareness of the reasons for adverse outcomes, diagnostic faculties must act more cautiously and responsibly to avoid more frequent legal liabilities for their recommendations in the future.

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I do hope you get this published!!!!!!!!

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Wonderfully accurate ~ best of luck with the publication! The 'increased level of patient awareness', for me, has been thanks to this wonderful forum and it's members, and posts like this! Thank you! x

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This is from "NHS Choices" and it should help:

"Unlicensed medicines

Sometimes a healthcare professional may recommend that you take an off-label or unlicensed medicine.

Off-label use means that the medicine isn't licensed for treatment of your condition. But the medicine will have a licence to treat another condition and will have undergone clinical trials for this.

Your doctor may recommend an unlicensed medication if they think it will treat your condition effectively and the benefits are greater than any risks."

nhs.uk/conditions/medicines...

It seems to me that there is no doubt that doctors can prescribe cheaper brands of T3, since they can do the above.

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Dolphin5,

There's never been doubt that they 'can'. The problem is they don't have to.

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My endo and GP are both very likeable people who seem to really believe that they are not allowed to, so I need to try to convince them that they can!!!

If by any chance they know they can, then it will get harder for them when I demonstrate that I know otherwise!

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Dolphin5,

I'm not trying to dissuade you. I hope you succeed in wearing them down.

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