August 2022 NHS Drug Tariff: Three additions to... - Thyroid UK

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August 2022 NHS Drug Tariff

helvellaAdministrator•

3 years ago•23 Replies

Three additions to the NHS Drug Tariff this month:

Levothyroxine sodium 75micrograms/5ml oral solution sugar free 100ml Category C Brillpharma Ltd

Liothyronine 10microgram capsules 28 Category C Roma Pharmaceuticals Ltd

Liothyronine 20microgram capsules 28 Category C Roma Pharmaceuticals Ltd

Liothyronine 5microgram capsules 28 Category C Roma Pharmaceuticals Ltd

NHS prices are £55, £65 and £55 respectively but are not listed in the tariff as they are the standard prices Roma charge.

Category C

2.2 Category C - Drugs which are not readily available as a generic, where the price is based on a particular proprietary product, manufacturer or as the case may be supplier. Endorsement of pack size is required if more than one pack is listed. Broken Bulk may be claimed, if necessary. Where the price of the product is based upon a non-proprietary product the price listed in this Part of the Drug Tariff is indicative of the price determined and in this case the Secretary of State determines the price to be the price listed by the manufacturer or as the case may be supplier on or before the 8th of the month being reimbursed.

drugtariff.nhsbsa.nhs.uk/#/...

Liothyronine tablet prices (and categories) for 28 tablets are:

Liothyronine 10microgram tablets £152.44 C Morningside Healthcare Ltd

Liothyronine 20microgram tablets £59.31 M

Liothyronine 5microgram tablets £99.47 A

drugtariff.nhsbsa.nhs.uk/#/...

You can see how 10microrgam tablets are still way out of line with 5 and 20 microgram tablets - due to there being a single supplier.

This is out of date - more recent information has been posted.

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23 Replies

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SarahJane14713 years ago

Thanks helvella . It’s terrible that these prices are so high and the NHS seems to be being held to ransom. Why does this continue to happen?

helvellaAdministrator• in reply toSarahJane14713 years ago

Well, at least Roma Capsules are £55 (5 and 20) or £65 (10).

Which is probably putting some pressure on prices of tablets.

Considering Advanz Pharma were claiming liothyronine was expensive to make, how come they are still supplying the product at something like a quarter the price they used to charge?

SarahJane1471• in reply tohelvella3 years ago

I forgot about the capsules 🤦‍♀️But would it not make sense to prescribe the 20s and cut into 4? Or is my maths really that shite 😂

helvellaAdministrator• in reply toSarahJane14713 years ago

Of course it would!

I'd be very happy if none of us had to split tablets. It is crazy that we have to.

What it all shows is that the cost of the Active Pharmaceutical Ingredient is irrelevant. Otherwise higher dosages would be more expensive! The cost of making tablets is surely much the same regardless the dosage?

SarahJane1471• in reply tohelvella3 years ago

So I know I’m sounding thick , but what prevents NHS and pharmacy’s buying from say Europe to get drugs cheaper?

helvellaAdministrator• in reply toSarahJane14713 years ago

The process, as I understand, is that it is almost invariably the company which approaches the MHRA to get a licence (marketing authorisation) and then negotiates with the NHS (the NHS Business Services Authority) a price.

There was a misguided assumption that commercial competition would result in price competition. That might work regarding paracetamol in supermarkets. It doesn't with liothyronine.

I agree. If the UK prices are out of step with those in the rest of the world, the NHSBSA should be able to source from anywhere. (With due consideration to quality, reliability of supply, etc.)

SarahJane1471• in reply tohelvella3 years ago

Ok 👍 this frustrates me even more ! NHSBSA Should get their act together. It could potentially save the country billions……… is that just my simple logic or am I missed something 🤷‍♀️

helvellaAdministrator• in reply toSarahJane14713 years ago

You are only missing the power to achieve change!

They seem to do a decent job of some products - but not others. At one time, I sort of felt they allowed liothyronine prices to be a bit high almost to make up for the low prices of levothyroxine. Something like, most money goes on levothyroxine, so concentrate on getting that price down.

But when the price difference is something like a hundred-fold between levothyroxine and liothyronine, or between Uni-Pharma T3 in Greece and liothyronine here, it is obviously not at all acceptable.

I have a nasty feeling that more or less the same issue applies to levothyroxine oral solution. Yes, I'd expect it to cost more than tablets, but fifty to a hundred times? Probably not justifiable.

SarahJane1471• in reply tohelvella3 years ago

🤬

Hpbr• in reply tohelvella3 years ago

Maybe they're having a sale? This whole debacle has me scratching my head. How a public body can be hoodwinked by profiteering and stand by and let it happen is beyond me. This is particularly galling when Turkish Tiromel liothyronine costs around £2.20 for 100x25 microgram tablets. They don't seem to have a problem with manufacture.

If they'd ditched that woeful, greedy supplier and made trade agreements with other reasonably priced manufacturers, then all this nonsense would not have happened. Surely there's a global marketplace?

The powers acted far, far too slowly, entangling themselves in red tape. What a total waste of money at the tax payers and thyroid patients expense. Business acumen and ability is severely lacking and common sense is totally absent. There is probably a reason but in my book, no excuse.

DippyDame3 years ago

The price of Lio to the NHS is absolutely beyond shocking! Yet, it can be bought abroad for a fraction of these tariff costs

Bad enough if patients are on low doses but for those who need supraphysiological doses to function this (frequently) means one thing.....trawling the planet to find reliable sources at a lower cost.

Fine ( well ridiculous in reality) for those with the technology, the means and the knowledge to obtain a private supply and to self medicate. Albeit with no ( or minimum) NHS support and safety net.

As for the people ( undoubtedly) suffering and even dying behind closed doors. They have no hope of either a correct diagnosis or correct medication.....because the former is frequently difficult to achieve and latter is too costly and outwith their reach.

It makes a mockery of so called levelling up!!

£152.44 for 28 tablets.....how do those people manage to sleep at night!!

helvellaAdministrator• in reply toDippyDame3 years ago

I also find it amazing that some countries also have 50 and/or 100 microgram liothyronine tablets!

Which I can only see as being for those like you who need very large doses. (Or they make them for veterinary purposes - which is their justification - but then supply them if pharmacies request them.)

DippyDame• in reply tohelvella3 years ago

I buy packs of 100 x 25mcg lio tablets at a price that should make the NHS hang their heads in shame!They work well for me

I have no need of 50 or 100 mcg T3 tablets

I did, during my early T3 adventure, take 212.5mcg for a time but I just multiplied up the number of tablets!

I always said I'd be better off asking the vet!!

The price of T3 is a scandal and is leaving people wrongly treated....and ill!!

Sorry having another soapbox moment...

Stourie• in reply toDippyDame3 years ago

I got 600 t3 for £84 and that’s only 14p per pill. X

asiatic3 years ago

Can you tell me the price of different doses of Carbimazole ? I take 75mg. by halving a 10mg. tablet alternate days. I intend to trial cutting back to 5mg soon and aware how illogical pricing can be wondered if I could save the NHS money by keeping on halving the 10mg tablets ( also Doc. doesn't need to know in case I want to adjust up later) 😉

helvellaAdministrator• in reply toasiatic3 years ago

Have a look at the British National Formulary prices:

Carbimazole Medicinal forms

bnf.nice.org.uk/drugs/carbi...

You will have to click on the ⋁ Show buttons to see the details. And the company names are distributors and manufacturers - not brands.

So far as I can see, you would save them a fortune by accepting only 5 milligram tablets! (Even if you increased back to 10 milligrams. Two 5s are massively less costly than one 10!)

asiatic• in reply tohelvella3 years ago

Thanks helvella. A previous google search seemed to point to this disparity and I thought " that can't be right " when apparently it can. When I asked at my pharmacy they were a bit cagey about prices. Looking at the BNF as you suggested , the brand I am given doesn't give an Indicative Price only the drug tariff price. No doubt a bit of wheeling and dealing goes on.

helvellaAdministrator• in reply toasiatic3 years ago

A fragment more information (this was directly from Advanz Pharma)

Carbimazole tablets: We only currently market the 20mg strength (NeoMercazole). All other strengths are discontinued for the foreseeable future.

Any prices for that exact product would, obviously, be nonsense if it is not available!

asiatic3 years ago

As I live in Scotland, I have just checked The Scottish Drug Tariff list and found they don't mention Carbimazole 10 mg. only 5mg. and 20mg. at 4 times the price. The pharmacy did take a few days to source it last time. Hope there's not going to be problems !

helvellaAdministrator• in reply toasiatic3 years ago

Not sure what you are seeing! 5 milligram - £2.68 per 100 and 20 milligram - £10.00 per 100. From Part 7:

isdscotland.org/health-topi...

asiatic• in reply tohelvella3 years ago

Yes but no mention of the price for Carbimazole 10mg which is what I am prescribed.

helvellaAdministrator• in reply toasiatic3 years ago

I agree it is confusing. I am wondering if the 10 and 15 are being phased out.