Netherlands: An end to irresponsible switching of thyroid medication levothyroxine

[helvella]

In the Netherlands, it has been established that patients will no longer be subject to more or less random switching of levothyroxine products.

This was agreed after issues with unavailability of the Thyrax product resulted in large numbers of patients ending up mis-dosed when switched.

Levothyroxine on 'red list'

An end to irresponsible switching of thyroid medication levothyroxine

After years of efforts by SON, levothyroxine is now on the red list of the Responsible Exchange of Medicines Guideline presented by the Netherlands Patient Federation on 20 May 2022 . This puts an end to the unnecessary and medically irresponsible switching of brands of levothyroxine .

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Not infrequently, switching levothyroxine in people with a thyroid disorder leads to health problems and a worsened quality of life. This was also apparent from the scientific study into the consequences of the Thyrax affair in 2016 for patients. Since then, patient organization SON has been committed to putting an end to irresponsible switching of levothyroxine , with success!

Extremely happy

The guideline offers patient organisations, pharmacists, health insurers and doctors clear tools to achieve a responsible change of medicines in practice. The corresponding red list contains medicines that, in principle, may not be exchanged. 'We are very happy and relieved that levothyroxine now has a place on that red list,' says director Marlies Mohr.

But that does not mean that switching levothyroxine no longer occurs at all. For example, an unforeseen circumstance such as a large stock shortage can lead to a change. Even if the patent on a certain brand expires, you may still be transferred to a generic medicine once.

Practice monitoring

'Of course, discussions can still arise in practice,' says Mohr. 'Partly for this reason, monitoring practice remains very important.' Patients can share their experiences via SON's Reporting Center levothyroxine . The parties involved meet regularly to discuss the practice and to include any points for improvement in the guideline.

Creation

The guideline has been developed after years of discussions between the Federation of Medical Specialists, the pharmacists' organization KNMP , general practitioners' organizations LHV and NHG , the Patient Federation of the Netherlands and health insurers in the Netherlands. Three patient organizations were also closely involved from the outset, including SON. 'Thanks to good consultation with all stakeholders – including my predecessor Rietje Meijer at the time – this fantastic result has been achieved. SON is 100% committed to all thyroid patients. That is possible thanks to our donors' , concludes Mohr.

Google translation of link:

schildklier-nl.translate.go...

Original Dutch language link:

schildklier.nl/over-son/vol...

I believe the same has also been agreed in Germany and am awaiting (I hope) some links to post.

[SlowDragon Administrator]

Is there a “Red list” of medications that shouldn’t have brand change in U.K.

If there is…..we need to campaign to get same result here

[RedApple Administrator]

This is very encouraging to hear!

I know many of us have repeatedly been told categorically by both medics and pharmacists that 'they are all the same'.

Do we have any organisations advocating for this in the UK I wonder?

[SlowDragon Administrator in reply to RedApple]

well the Government guidelines are pushing for this

gov.uk/drug-safety-update/l...

If a patient reports persistent symptoms when switching between different levothyroxine tablet formulations, consider consistently prescribing a specific product known to be well tolerated by the patient. 

Yet still GP’s and pharmacies frequently deny that different people react differently to different brands levothyroxine

[RedApple Administrator in reply to SlowDragon]

The problem is use of the word 'consider '. It needs to be prohibited unless there are exceptional circumstances such as a brand being withdraw from the market etc.

[SlowDragon Administrator in reply to RedApple]

agreed

Another thing to campaign for