GP not prepared to prescribe a brand of T3

[mischa]

I have been having some difficulty obtaining Advanz Pharma Lionthyronine. I assume it is the same as Mercury Pharma. I have been on this brand for some nine years.

My pharmacy keeps giving me a different brand which I refuse, then they order the brand I normally use. This has been going for for many months but they do eventually get the brand I like.

Recently, I asked my GP if they would write on my prescription the brand I usually use.

I have just received a text from her telling me that - '...I sought advice from the Medicines Management Team who support us with prescribing decisions. In this case, they were unable to find any evidence of significant differences between UK-licensed liothyronine products. [my emphasis] Advanz Pharma Liothyronine is much more expensive than other brands and so based on this I don't feel able to prescribe this brand....'

Can anyone offer an alternative argument than the one above. That there is no significant difference between brands. I have had other brands and I find that there is a difference. If there wasn't I would be quite happy to use cheaper brands.

I want to go back to her and argue my case but feel I need to put a stronger case to her other than how I feel on other brands.

Has anyone else had experiences with different brands and find that there is a difference in how they feel on them.

Or can someone suggest a brand that is similar to Advanz Pharma/Mercury Pharma.

Thank you.

[Jaydee1507 Administrator]

This is really difficult when it's basically coming down to cost. I'm not fully versed on the prescribing costs of each brand but certainly some are quite a bit more costly than others.

The government put out this drug safety update that relates to Levothyroxine and the differences between brands, recommending prescribing a specific product. perhaps you could use it to draw parallels for Liothyronine? For Levo they even suggest prescribing liquid Levo which is super expensive at several hundred pounds a bottle.

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

[mischa in reply to Jaydee1507]

Thank you for the link. It's very helpful.

I am also looking at the price of T3 and it appears it has reduced in price over the years.

[Jaydee1507 Administrator in reply to mischa]

I'm sure helvella has the low down on T3 prices. There was a massive price hike a few years ago that saw many hypo people get their NHS prescriptions stopped due to cost. Price is slowly but steadily falling again following the T3 supplier being taken to court and fined a large sum of money for price gouging!

[mischa in reply to Jaydee1507]

have just posted for helvella and/or SlowDragon about prices.

Thank you for getting back to me Jaydee1507.

[Jaydee1507 Administrator in reply to mischa]

Could probably have just tagged them in a post here. 🙂

[mischa in reply to Jaydee1507]

How do I tag?

[Jaydee1507 Administrator in reply to mischa]

you write @ then the name (no space after the @ ). A drop down box of possible members pops up and you select the one you want.

[mischa in reply to Jaydee1507]

Eventually I managed to do it on a new post.

Thank you for your patience.

[Aurealis]

it’s helpful if you use the term ‘bioequivalence’ when suggesting that there’s a difference between brands. It is established fact that different brands are sometimes processed differently by individuals. In contrast they’re really touchy over any suggestion that brands are different… because they have the same active ingredients. NICE suggest re-testing after a change in brand precisely because the bioequivalence of different brands can be different- that is, different brands can be processed differently by our bodies.

[mischa in reply to Aurealis]

Thank you Aurealis for that information. I have been given different brands but they don't seem to be as effective as Mercury Pharma for me.

[crimple]

mischa, is the issue with the fillers in the meds? I cannot tolerate acacia powder, so my scrip specifies Sigma Pharma Liothyronine and Almus Levothyroxine.

Some people cannot tolerate mannitol or lactose.

Helvella's meds list shows what "fillers" are in the various brands.

[helvella Administrator Thyroid UK in reply to crimple]

Just to be clear - I only identify some excipients!

But there are links to documents which have the full information.

(Don't want anyone expecting more than there is.)

[mischa in reply to crimple]

That's interesting. It could be fillers - I do have bloating issues.

[crimple]

mischa, what brand(s) of thyroid meds are you taking. TEVA is known to be a problem for many folks on here. I know it has acacia powder, gave me terrible stomach pains, I think it also has lactose. Do not ever let a pharmacist or GP tell you that the fillers/excipients are irrelevant. My scrip is quite clear about what brands I need and 99% of time the pharmacy gets it right.