NHS prices for liothyronine: Can someone let me... - Thyroid UK

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NHS prices for liothyronine

2pence profile image
63 Replies

Can someone let me know the NHS prices for all three Liothyronine tablets as I don't appear to have the link on my laptop and can't read the drug tariff on my phone as the screen is too small. I know that the 20mcg price is £59 but don't know the 5mcg and 10mcg prices.

I had a conversation today with the pharmacist at the local pharmacy who kept referring to the Liothyronine tablets as milligrams rather than micrograms which didn't increase my confidence so I'm looking at changing the pharmacy my prescriptions are sent to.

63 Replies
RedApple profile image
RedAppleAdministrator

helvella

helvella profile image
helvellaAdministrator

NHS Drug Tariff prices are:

£99.47 for 5 microgram tablets.

£152.44 for 10 microgram tablets.

Remember, if it helps, Roma capsules are £55 (5 and 20) or £65 (10). (The are actual prices.)

Private prescriptions will be much more expensive. And the price the pharmacy has to pay could also be higher.

RedApple

Aurealis profile image
Aurealis in reply to helvella

Drug tariff price - this is the maximum amount the NHS will pay?

£99.47 for 5 microgram tablets.

£152.44 for 10 microgram tablets.

£59 for 20mcg

Is this right?

Why?

Does it make sense? The 20mcg tablets woukd be much better value!

Why would private prescriptions cost much more?

2pence why do you need this information and what can you do with it? (Sorry if this seems obvious, I’m just at a loss as to what is going on in pharmacies / the NHS and GP practices regarding Liothyronine, and wondering if you know better than me, how to get the tablets you need)

helvella profile image
helvellaAdministrator in reply to Aurealis

There are changes going through about how much the pharmacy can make on medicines - generic and branded. But yes, the tariff price is approximately what the NHS will pay.

The prices depend on things like competition. If there is only one supplier of 10 microgram tablets, they can charge more (negotiate a higher price)!

There is clearly absolutely no relationship between the amount of Active Pharmaceutical Ingredient (API) and the price. And, except in rare cases, the other ingredients will be pretty low in cost.

Private prescriptions appear to be charged at something towards 100% more than NHS prices. But I believe they have the choice to charge differently. Which is why it is worth ringing round if you need to get anything on private prescription.

Remember, I know little and have no particular sources of information. It really isn't at all clear how all these things work!

Hypopotamus profile image
Hypopotamus in reply to helvella

Is that the price per tablet? There isn't any reason why it shouldn't be as cheap as thyroxine AFAIK.

helvella profile image
helvellaAdministrator in reply to Hypopotamus

No - the price for the usual 28 tablets that are prescribed.

Pharmacist2019 profile image
Pharmacist2019 in reply to Hypopotamus

It's because the number of manufacturers are small and decided on this pharmaceutical-journal.com/...

Aurealis profile image
Aurealis in reply to Pharmacist2019

what do you mean decided on this? It’s behind a paywall, can you explain please

Pharmacist2019 profile image
Pharmacist2019 in reply to Aurealis

see the link about liothyronine price fixing and CMA involvement or google it

SlowDragon profile image
SlowDragonAdministrator in reply to Aurealis

it was price gouging

Only one supplier, who changed liothyronine category to generic medication ….

Generic medications have no price control,Maz it’s assumed competition between brands will drive price downward….

But with only one licensed supplier….they increased price by 6000%

gov.uk/government/news/cma-...

Now fined and four suppliers licensed

competition between the four brands has resulted in drop in price from £268 per 28 tablets…..currently £59 per 28 tablets and £55 for 5mcg, 10mcg and 20mcg capsules

And price is dropping each month

But only one supplier for 5mcg and 10mcg tablets so price remains high

Aurealis profile image
Aurealis in reply to SlowDragon

but it’s a drop in tariff price only for 20mcg isn’t it? So brands that are charged at above the tariff price aren’t supplied at all? The free market approach to health… ?

SlowDragon profile image
SlowDragonAdministrator in reply to Aurealis

Capsules only very recently been licensed

Prior to that ….only one licensed supplier of 5mcg and 10mcg tablets

Indigourchin profile image
Indigourchin

i just paid £60 for a private prescription of T3, 100 tablets of 20 mcg.

Cornwaller profile image
Cornwaller in reply to Indigourchin

Why the NHS pays such crazy prices is simply shocking; Liothyronine is available internationally for a tiny fraction of these prices and I don't for one moment accept that the Liothyronine purchased by the NHS is in sone mysterious way better or safer than that used in other countries around the world.

Even worse the super inflated price helps pervert clinical practice.

helvella profile image
helvellaAdministrator in reply to Cornwaller

It is, I think, made even clearer by the appearance of a Greek-made product as the lowest price product in each dosage (Roma capsules). They would not have been accepted if not able to pass the processes required.

I suspect that the UK company chose a price below all existing products intentionally.

But I'd not be at all surprised if there were a very generous margin to allow for future price cuts if or when other products reduce their prices. And, by being the only capsule product, once a prescription has changed to specify "capsule", the patient's prescriptions end up being captive to them. (Unless another capsule product is launched.)

The fact that Thybon Henning has had a fairly stable, and lower, price within Germany for many years can also be considered good evidence.

Pharmacist2019 profile image
Pharmacist2019 in reply to helvella

The NHS have changed their discount scales for pharmacies from 1st October.

They will clawback

Generic medicines – 17.52%

Branded medicines – 5.00%

This makes the liothyronine 17.52% cheaper for the surgery to prescribe generically

psnc.org.uk/wp-content/uplo...

helvella profile image
helvellaAdministrator in reply to Pharmacist2019

Are you able to explain for the NHS Indicative Price, NHS Drug Tariff price, what the pharmacy pays, and what the pharmacy gets paid all work? And where the clawback occurs!

Pharmacist2019 profile image
Pharmacist2019 in reply to helvella

The NHS pays the drug tariff price minus the clawback to the pharmacy.

The pharmacy aims to buy the drugs below this price and make around 20% margin. Therefore buying for around 40% less than the tariff price.

Eg Tariff is £50, pharmacy gets paid £41.50 and aims to buy at around £30-35 is the easiest example I can use

helvella profile image
helvellaAdministrator in reply to Pharmacist2019

Thank you!

Aurealis profile image
Aurealis in reply to Pharmacist2019

so does that mean the pharmacy makes a profit equivalent to the clawback + 20% margin (the aim anyway)

Pharmacist2019 profile image
Pharmacist2019 in reply to Aurealis

That's correct, as the profit is what pays the bills (heating, lighting, staffing, rent, rates etc)

BrynGlas profile image
BrynGlas in reply to Cornwaller

Indeed I pay about £12 for T3 x 25mcg x 100 tablets. Why the NHS pays so much is totally beyond me.

Diesel378 profile image
Diesel378 in reply to BrynGlas

I wouldwould ikea to restart T3 Levothyroxine not working g for me constantly tired /sleeping I used to access the from Greece and Andorra Where can I buy them now ? Can you help Id6 be very grateful Thankyou

Johanna Grant 🙂

Aurealis profile image
Aurealis in reply to BrynGlas

what brand are they please?

Aurealis profile image
Aurealis in reply to Indigourchin

and what brand are they?

Indigourchin profile image
Indigourchin in reply to Aurealis

Thybon Henning

SlowDragon profile image
SlowDragonAdministrator

Thybon Henning 20mcg tablets on private prescription are 50-60p per tablet…in boxes of 100

Substantially cheaper

Pharmacist2019 profile image
Pharmacist2019 in reply to SlowDragon

Chemist4U are able to supply on private prescriptions at that price and always have availability

Aurealis profile image
Aurealis in reply to SlowDragon

do we know anything about the differences between Liothyronine sodium and Liothyronine hydrochloride (thybon henning). For instance, is the thybon product better from the point of view of limiting sodium intake to control blood pressure ?

Pharmacist2019 profile image
Pharmacist2019 in reply to Aurealis

Liothyronine hydrochloride (thybon henning) isn't licensed in the UK, but licensed in Europe, hence can be imported and the price isn't controlled by UK pharma. There are no differences, just the salt in which the drug is sat in

SlowDragon profile image
SlowDragonAdministrator in reply to Aurealis

many people prefer Thybon Henning

It’s also lactose free

Steni profile image
Steni

I have just come back from Greece where I bought 8 packets of Uni Pharma (?) for 2 Euros a packet of 20mg tablets without a prescription .

Kityfitz profile image
Kityfitz in reply to Steni

used to be 1euro 13 cents for 28 tablets - inflation I guess. But seriously though, how can the NHS be paying so much?

CoeliacMum1 profile image
CoeliacMum1

I’ve just paid £75 for 28 x 20mcg Morningside Liothyronine private prescription for NHS regulated and did for Mercury Pharma ones previously.

Probably be my last as my lot.

As my consultant is stopping private practice.🙄

2pence profile image
2pence

Thanks for all your replies. The pharmacy my prescription is currently sent told me for two weeks that Morningside Liothyronine 20mcg is out of stock and are now telling me that all 20mcg Liothyronine prices have shot up ( Morningside to £167 per box) and they aren’t allowed to order them. It says Morningside on the prescription ( not sure where as don’t get to see the actual prescription). The pharmacies solution is for my prescription to be all in 5mcg tablets so 5 boxes per month for my 25 mcg prescribed dose. I don’t believe that Morningside 20mcg tablets cost that much and feel that the pharmacy are trying to make money.

I’m picking up a printed prescription today and will get that filled elsewhere. Since moving house I’ve had four repeat prescriptions and have had to have a printed prescription three times to get the 20mcg tablets.

helvella profile image
helvellaAdministrator in reply to 2pence

I suggest considering asking for your prescription to be changed to "capsules" or not specify whether it is tablets or capsules (if that is legitimate). Then they could dispense Roma at a known price.

(Sorry if there is some reason they wouldn't suit you - I find it hard remembering all the issues members have! :-) )

SlowDragon profile image
SlowDragonAdministrator in reply to 2pence

this is presumably a private prescription?

25mcg per day …..just cut 20mcg into 1/4’s to get 5mcg dose

Suggest you try some of the online pharmacies

thyroiduk.org/if-you-are-hy...

Aurealis profile image
Aurealis in reply to 2pence

that sounds like a nightmare. I’m having the opposite problem - Morningside available at all pharmacies but no Mercury Pharma. It isn’t a national problem, it’s locality based.

Pharmacist2019 profile image
Pharmacist2019 in reply to Aurealis

Use a different pharmacy, you can change your nomination via the NHS app

RedApple profile image
RedAppleAdministrator in reply to Pharmacist2019

Pharmacist2019 'you can change your nomination via the NHS app'

Only if you are in England or the Isle of Man. Other parts of the UK have different arrangements.

Aurealis profile image
Aurealis in reply to Pharmacist2019

I have, twice, pharmacists all saying the same thing…

Pharmacist2019 profile image
Pharmacist2019 in reply to Aurealis

DM me if you want me to recommend a pharmacy in england

Pharmacist2019 profile image
Pharmacist2019

The NHS reimbursement prices to pharmacies can be found at drugtariff.nhsbsa.nhs.uk/#/...

Liothyronine 10microgram capsules 28 £65.00 Roma Pharmaceuticals Ltd

Liothyronine 10microgram tablets 28 £152.44 Morningside Healthcare Ltd

Liothyronine 20microgram capsules 28 £55.00 Roma Pharmaceuticals Ltd

Liothyronine 20microgram tablets 28 £59.31

Liothyronine 5microgram capsules 28 £55.00 Roma Pharmaceuticals Ltd

Liothyronine 5microgram tablets 28 £99.47

They will change on the 1st October 2022 again. That's what the NHS pay per box and effectively what the surgery gets charge

2pence profile image
2pence

I have/am considering that but want to get my annual bloods done first and then need to see the GP. I can hopefully get a face to face due to my deafness as the surgery seem to want to do everything online or by phone.

My OH has a wrist/hand problem and it was diagnosed as not broken over the phone. He has not been seen despite being a type 1 diabetic and the warnings around that. Fortunately the hand clinic this week is face to face at the hospital.

Loulabelle70 profile image
Loulabelle70

i paid £59 for 2 month supply of Lyothyronine. These prices being quoted are very high! Someone's making money somewhere and it's not the NHS!

Sarahbob profile image
Sarahbob

I buy my own online. I have just received an order of 300 Tiromel 20mcg for £51.33 including the postage. £36 without postage.

This is readily available online without a prescription.

debra_bill profile image
debra_bill

I also purchase T3 online with no prescription.

Pharmacist2019 profile image
Pharmacist2019 in reply to debra_bill

That would be illegal. I would question whether the meds are authentic

helvella profile image
helvellaAdministrator in reply to Pharmacist2019

I don't believe it is illegal from the UK perspective provided it is for self and household.

Though questions over authenticity are, of course, very important.

Human Medicines Regulations 2012.

PART 3 Manufacturing and wholesale dealing

Grant etc of licences

Manufacturing of medicinal products

17.—(1) A person may not except in accordance with a licence (a “manufacturer’s licence”)—

(a)manufacture, assemble or import from a state other than an EEA State any medicinal product; or

(b)possess a medicinal product for the purpose of any activity in sub-paragraph (a).

(2) Paragraph (1) is subject to paragraphs (3) to (5).

(3) Paragraph (1) applies in relation to an investigational medicinal product only—

(a)if the product has a marketing authorisation, Article 126a authorisation, certificate of registration or traditional herbal registration; and

(b)to the extent that the manufacture or assembly of the product is in accordance with the terms and conditions of that authorisation, certificate or registration.

(4) In paragraph (3), “marketing authorisation” means—

(a)a marketing authorisation issued by a competent authority in accordance with the 2001 Directive; or

(b)an EU marketing authorisation.

(5) Paragraph (1) does not apply to a person who, in connection with the importation of a medicinal product from a state other than an EEA State—

(a)provides facilities solely for transporting the product; or

(b)acting as an import agent, imports the medicinal product solely to the order of another person who holds a manufacturer’s licence authorising the importation of the product.

(6) Paragraph (1) does not apply to a person who imports a medicinal product for administration to himself or herself or to any other person who is a member of that person’s household.

legislation.gov.uk/uksi/201...

humanbean profile image
humanbean in reply to Pharmacist2019

It would only be illegal with current laws if T3 was on the government's controlled drugs list.

gov.uk/government/publicati...

Lots of people in the UK buy prescription drugs online and import them.

If people can't get the drugs they need to live a half-decent life (like T3) they have no choice. I live in fear of the MHRA making it illegal.

Pharmacist2019 profile image
Pharmacist2019 in reply to humanbean

Anybody can import up to 90 days of a prescription only medicine for their personal consumption into the UK. What I am questioning is obtaining from a European country without a prescription (unless eastern block). Liothyronine in most european countries is prescription only and there must be some form of prescription, unless over the counter in a certain country

StitchFairy profile image
StitchFairy in reply to Pharmacist2019

So you're not saying it's illegal for us to purchase without prescription, but it is illegal for European pharmacies to sell to us without prescription?

Pharmacist2019 profile image
Pharmacist2019 in reply to StitchFairy

Not illegal for the individual, but for the supplier. Pharmacies cannot simply dish out prescription only medicines, with no prescription. This becomes a free for all with no monitoring and everyone self-diagnosing

StitchFairy profile image
StitchFairy in reply to Pharmacist2019

People wouldn't need to do this if doctors were better at their job.

helvella profile image
helvellaAdministrator in reply to Pharmacist2019

I have never found a legal basis for a 90 day limit.

Just a few statements without, so far as I am aware, the force of law.

Pharmacist2019 profile image
Pharmacist2019 in reply to helvella

It's not written anywhere in statute, its more if you were caught importing via customs (postal or airport), what quantity do they turn a blind eye to and what's imported for resale. The USA adopt the same policy help.cbp.gov/s/article/Arti...

helvella profile image
helvellaAdministrator in reply to Pharmacist2019

Thank you Pharmacist2019,

Big difference, though, is that the USA has this:

A valid prescription or doctors note is required on all medication entering the United States.

And those on T3 might need anything from, say, 2.5 to even 100 or more micrograms a day. A massive spread. Very difficult and wrong to apply any time to a specific quantity on the basis of ordered quantity only. Especially difficult when someone first tries T3.

Also, if purchasing by any form of internet supply, HMRC/Border Force would have to maintain information over time to preclude simply making multiple small purchases. And do so across all members of a household to prevent person and partner both buying separately.

debra_bill profile image
debra_bill in reply to Pharmacist2019

I don't obtain my T3 from Europe.

debra_bill profile image
debra_bill in reply to Pharmacist2019

Please be careful when making statments of fact like that, it is perfectly legal, as they are for my own use only.

I agree that buying meds online is risky, but NICE & the NHS are not helping people.

I was prescribed T3 by an endo over 20 years ago, because T4 alone doesn't work for me. NICE did their great deal for T3 and suddenly it seems I'm fine and don't need T3 after all.

My doctor refuses a private presciption to allow me to buy safely, presumably because that would make her a hypocrite. I either need T3 or I don't. Funnily enough stopping nearly destroyed my relationships and career.

Some may choose to spend their life in ill health and misery, but I chose to do something about it.

SlowDragon profile image
SlowDragonAdministrator in reply to Pharmacist2019

NHS endocrinologists, are under pressure not to prescribe T3, and some have suggested to members to buy T3 online without prescription

bbc.co.uk/news/business-420...

Number of prescriptions fell dramatically as price rose

thelancet.com/journals/land...

Fortunately as price is now dropping number getting prescription on NHS is increasing back up

Pharmacist2019 profile image
Pharmacist2019

Thybon Hennings 20mcg on private prescription should be around 50p a tablet or £15 a month. Anything more and you should question and shop around.

TaraJR profile image
TaraJR

The October drug tariff has been released today.

Roma T3 20mcg capsules are still £55.

T3 20mcg tablets are reducing from £59.31 to £56.19.

I know it's still way too much, but I'm posting for up to date info.

If a patient wants tablets, not capsules, I'd suggest they say they're the same price.

nhsbsa.nhs.uk/sites/default...

TaraJR profile image
TaraJR

As a matter of interest, Thyroid Support Group Norfolk won their 3-year campaign to get T3 reinstated which finally happened in 2020.

This year they gave the group data showing that, although the number of T3 prescriptions has risen in Norfolk, the price paid has gone down because the cost of T3 has reduced so much (over an 80% reduction) So allowing T3 does not open a floodgate and break the bank.

This data is included in the joint thyroid groups' latest "T3 Prescribing Report 2022", which shows that over half of CCGs/ICBS do not follow the national guidance. Use this wherever is helpful!

thyroidtrust.org/uploads/3/...

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