Billy Kenber's summary of extensive new CMA documents on Advanz

[TaraJR]

Billy Kenber broke the T3 story years ago, and he follows the CMA investigation closely. Extensive new CMA documents are here (scroll down) gov.uk/cma-cases/pharmaceut...

They are very long, hence Billy tweeted some summary points: "Yesterday the CMA published a 400 page decision notice which includes extracts from a bunch of internal documents obtained during their investigation. They lift the lid on how brazen execs at Advanz were about this price-hiking business model.

The docs show that execs thought they could fly "below the radar" because the NHS and DHSC had limited resources and were focused on expensive new medicine.

The business model was simple. No need for expensive R&D. Instead find old, niche drugs which no-one else was making in the UK. They then wanted to jack up the price - often through a series of smaller increases to avoid unwanted attention.

Now obviously the NHS doesn't want companies to do this and it had profit controls in place on branded drugs which meant if you increase the price of one you have to reduce another. However Advanz - or rather its predecessor Mercury Pharma - found a way round this.

They outlined this in a 2007 internal memo called 'Branded Pharmaceuticals UK Business Plan'. It laid out how dropping a brand name could circumvent these controls. The NHS allows free pricing for unbranded generic drugs because competition normally keeps them cheap.

The lack of other suppliers meant that didn't apply here. Liothyronine cost less than £4 a packet in 2007. It would reach a peak of £250 in 2016. As it began to rise in price executives boasted that there was no impact on prescriptions. Patients didn't have an alternative.

The company showed off to investors, using liothyronine as an example of its "pricing expertise". Other documents show price increases were suggested when the company was on track to miss financial targets.

Here's another internal slide for investors - this one is from 2012 and lays out the business strategy. That was the year the company was bought by the private equity house Cinven for £465 million.

Cinven's investment committee concluded it was a good buy because Advanz "operates below the radar and capitalises on opportunities to achieve volume and pricing growth even in such a heavily regulated market".

It bought another pharma company in the same year and applied the same strategy to its portfolio. The CMA-obtained docs show the business plan included "price optimisation: de-branding products in strong market positions to optimise pricing".

Cinven sold the new merged company on for £2.3 billion in 2015 but prices continued to rise. That was the same year liothyronine was put on an NHS 'drop list' because it was now so expensive. The cost to the NHS rose from £600k a year to £30m.

For those on Twitter:

twitter.com/billykenber/sta...

[Hennerton]

Thank you for posting this and it is brilliant to see how Billy Kenber has revealed the awful tale of duping the NHS.

I wrote to my MP and the NHS in 2013 about the price hikes and received utterly feeble excuses, including one from Earl Howe in the House of Lords, which I sent on to Billy. Earl Howe cited difficulty of manufacture and transport costs for the reasons. Oh please! We are not stupid as Billy has now proved. Great piece of investigation by him and perhaps now an even lower price for Liothyronine?

[SlowDragon Administrator]

Full document here ……

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[jimh111]

The CMA have done a wonderful job. They are only allowed to investigate if the expected savings exceed their costs by a factor of 10, they have to save £10 for every £1 they save. This seems excessive caution, perhaps because many politicians have investments in businesses. The biggest blame must lie with the NHS who were too lazy to tackle the problem.