UK drug companies fined £260m for inflating prices for NHS

[helvella]

First thing to note - this covers hydrocortisone - NOT liothyronine. However, the basis of de-branding, at least superficially, is extremely close to the liothyronine issues.

Whilst £260 million is a lot of money - the NHS was over-paying by up to £80 million each year. I wonder how the totals costs balance? I suspect the NHS still loses out - a lot.

UK drug companies fined £260m for inflating prices for NHS

Watchdog issues warning after abuses that included paying would-be rivals to stay out of the market

The shelves of a dispensing pharmacy. Accord-UK, Accord Healthcare and parent company Intas are liable for £44.4m. Photograph: Alamy

Jillian Ambrose

Thu 15 Jul 2021 08.39 BST

Last modified on Thu 15 Jul 2021 08.40 BST

The UK’s competition watchdog has imposed fines totalling more than £260m on pharmaceutical companies after an investigation found that they overcharged the NHS for hydrocortisone tablets for almost a decade.

The Competition and Markets Authority (CMA) found that drugs makers Auden Mckenzie and Actavis UK, now known as Accord-UK, used their position as the sole providers of hydrocortisone to inflate the price of drug. Tens of thousands of people in the UK depend on hydrocortisone tablets to treat adrenal insufficiency, which includes life-threatening conditions such as Addison’s disease, the CMA said.

The investigation found that the companies were able to inflate the price of hydrocortisone tablets by over 10,000% comparedwith the original branded version on sale in 2008. This meant the amount the NHS had to pay for a single pack of 10mg tablets rose from 70p in April 2008 to £88 by March 2016.

The companies also paid would-be rivals to stay out of the market, the watchdog found.

“These are without doubt some of the most serious abuses we have uncovered in recent years,” said Andrea Coscelli, chief executive at the CMA. “The actions of these firms cost the NHS – and therefore taxpayers – hundreds of millions of pounds.”

Before April 2008, the NHS spent about £500,000 a year on hydrocortisone tablets, but this had risen to more than £80m by 2016.

The decision to hike the price of de-branded drugs meant that the NHS “had no choice but to pay huge sums of taxpayers’ money for life-saving medicines” and reduce the money available for patient care”, Coscelli said.

“Our fine serves as a warning to any other drug firm planning to exploit the NHS,” he added.

The CMA has found that Accord-UK should be held solely liable for £65.6m of the total £260m fine, while its former parent company, Allergan, should be solely liable for £109.1m. The pair are jointly liable for a further £2m. Accord-UK, Accord Healthcare and the company’s current parent company Intas are jointly and severally liable for £44.4m.

The CMA’s total fine for AMCo’s conduct is £42.8m, and for Waymade is £2.5m.

theguardian.com/business/20...

[Hidden]

The high cost of some brands of Hydrocortisone has affected many of us with adrenal insufficiency with some pharmacies trying to give us cheaper versions of Hydrocortisone because of the cost. Although the cheaper versions have been okay for some, others have experienced issues usually due to the fillers they use in the tablets. Many of us have to split the tablets to get our correct dose however some of the cheaper brands are not designed to be split as they aren't scored into quarters, this means that the Hydrocortisone isn't spread equally into all 4 quarters. Like Levothyroxine we're recommended to have the same brand each time which if a specific brand is not specified on the script the pharmacy can give any brand. The cost of HC tablets went from 76p a packet in 2008 to £88 per packet - no wonder they have eventually been fined! It took several reporters to run the story before the health minister decided to do something about it!

[helvella Administrator Thyroid UK in reply to Hidden]

It is so obvious that such medicines should be readily available in low dosages - and at sensible prices - it is staggering that a giant organisation such as the NHS is so unable to flex its muscle and get the products at an acceptable price.

[Hidden in reply to helvella]

Unfortunately Hydrocortisone only comes in 10 mgs tablets so most of us have to split them into smaller doses so it's essential to have brands that can be split.

[helvella Administrator Thyroid UK in reply to Hidden]

But it should come in smaller dosages. Why cannot the NHS put out a contract to get 2.5 or 5 milligram tablets (or whatever other doages make sense) made rather than forcing patients to split - especially with the issues of uneven dosing?

They are not using the muscle they have - for whatever reason.

[Hidden in reply to helvella]

Crazy isn't it?!

[LindaC in reply to helvella]

As with Liothyroinine, I've regularly said, "A couple of 'A' Level Business Studies' students could have negotiated better purchasing deals! Of course, a moments thought... there is clearly more to it than that.

[shaws Administrator in reply to helvella]

Some people who source tablets might get a 'reward' if they order from some companies.

[shaws Administrator]

Thanks for posting helvella. It's about time companies were investigated to see why their prices were so high.

[Angel_of_the_North]

Sadly the fines are so low compared to their profits that they'll probably just do it again.

[helvella Administrator Thyroid UK in reply to Angel_of_the_North]

It is an abuse that deserves the terms fraud and racketeering. Which are criminal offences which often, if prosecuted, result in gaol.

That never appears to be the possibility of the directors (or whoever else) involved losing their liberty. Prison should be a real concern of those who made the decisions. Obviously, the decision to impose a custodial sentence lies with the courts. But we have a system in which peoiple have been thrown inside for failing to pay for a TV licence - how much more approrpiate to this sort of behaviour?

Even without gaol, the fines all appear to be imposed on the companies - not the individuals.

The other day, Southern Water received a £90 million fine for releasing untreated sewage (regarded as quite a high penalty). Numerically, this is almost three times as bad.

[Tythrop]

Institutional corruption?

[userotc]

It's unheard of for me to defend pharma companies but a price is what the customer will pay. So I think the bulk of the blame probably lies with the NHS and the Government.

If they encouraged (rather than discouraged) non-pharma options for disease instead of "a pill for an ill" approach, theyre less likely to be ripped off by greedy pharma (see, I soon stopped defending them!).

[TaraJR]

From the Evening Standard article: "The CMA said Auden Mckenzie’s decision to raise prices for de-branded drugs meant that the NHS had no choice but to pay huge sums of taxpayers’ money for life-saving medicines.”

WHY did the NHS have no choice? There must be other suppliers abroad who they could buy from? Does NHS have no free will?! Why does the NHS procurement system have more power, or willingness, to buy from somewhere else?

The same applies to T3 of course, which the CMA is STILL investigating after about 5 years.

[helvella Administrator Thyroid UK in reply to TaraJR]

As it stands, it appears that the NHS simply cannot procure unlicensed products when licensed products exist and are available.

(Or that is how it appears to me - without any in-depth understanding.)

I'll not be surprised if the CMA's liothyronine investigation concludes fairly soon.

[G0ddessNvrN0tBrOken in reply to helvella]

Can you guys come to the States and bring your watch dogs over here? I was just going to say because one of my MS drugs is $5k a month and I thought it was like $2k or $1.5k a month there but I just read it got cut down 26% to £513.00 so that would be around $800.00 approx for someone rly tired doing math at 3 in the morning. However you get my point. Omg things are so wrong here. Do doctors there no give pain meds either like the states? And Australia and Canada? Or are they good hopefully? We are in a deep horrible pain depression. I was put on this drug because I had really bad syncope, fainting and low blood pressure. And I am really knocking myself on the head bc I usually do my due diligence but I trust that dr and I didn’t think he wld put me on something not good for me but I have gotten a fungal infection and shingles since i have been on this. Two things it talks about. Could be coincidence. Could he not. All right bed time for me. Thanks for listening !