Liothyronine prescribing in England: costs versus need

In 2021, we reported how large price increases for liothyronine over 2012–20 had caused a reduction in the prescription of liothyronine and suggested that NDT could be a cost-effective alternative treatment.2 An investigation was opened by the UK Competition and Market Authority (CMA) in October, 20...

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Bibliographic Details
Published in:The Lancet (British edition) 2023-12, Vol.402 (10417), p.2074-2075
Main Authors: Heald, Adrian, Stedman, Mike, Okosieme, Buchi, Premawardhana, Lakdasa, Taylor, Peter, Dayan, Colin
Format: Article
Language:English
Subjects:
Costs
Costs and Cost Analysis
Drug Costs
Drug Prescriptions
England
Humans
Practice Patterns, Physicians
Prescriptions
Primary care
Thyroid
Thyroid gland
Thyroxine
Triiodothyronine
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Summary:In 2021, we reported how large price increases for liothyronine over 2012–20 had caused a reduction in the prescription of liothyronine and suggested that NDT could be a cost-effective alternative treatment.2 An investigation was opened by the UK Competition and Market Authority (CMA) in October, 2016, into prices for liothyronine tablets. The outcome of the CMA investigation was made public on Dec 15, 2020, and the suppliers were fined over £101 million.3 The British Thyroid Association (BTA) recognises that a proportion of individuals have substantial dissatisfaction with levothyroxine and have published guidance on use of liothyronine.4 The guidance suggests that liothyronine can be prescribed if symptoms persist on levothyroxine, at a daily dose of 5–10 μg split twice a day. Liothyronine costs fell after the CMA ruling, but remain orders of magnitude higher than levothyroxine and the pre-increase levels of liothyronine.
ISSN:0140-6736
1474-547X
DOI:10.1016/S0140-6736(23)01792-0