Question to the Department of Health and Social Care:

To ask the Secretary of State for Health and Social Care, what assessment his Department has made of the (a) affordability and (b) NHS procurement options for Liothyronine T3.

The costs of branded medicines are controlled by the Pharmaceutical Price Regulation Scheme and the statutory scheme for branded medicines. Liothyronine is an unbranded generic medicine. For unbranded generic medicines, the Department encourages competition between suppliers to keep prices down. In primary care, community pharmacies are incentivised to source products at the lowest possible cost and in secondary care, competitive tenders ensure value-for-money to the National Health Service.

Liothyronine is currently the subject of an investigation by the Competition and Markets Authority, which has provisionally found that the single supplier of the product abused its dominant position to overcharge the NHS by millions of pounds for liothyronine tablets. A provisional decision does not necessarily lead to an infringement decision. Where companies have breached competition law, the Department will seek damages and invest that money back into the NHS.

Liothyronine was included in NHS England guidance last year; ‘Items which should not routinely be prescribed in primary care’ because more cost effective products than liothyronine are available. That guidance recommends that:

- prescribers in primary care should not initiate liothyronine for any new patient;

- individuals currently prescribed liothyronine should be reviewed by a consultant NHS endocrinologist with consideration given to switching to levothyroxine where clinically appropriate; and

- a local decision, involving the Area Prescribing Committee (or equivalent) informed by National guidance (e.g. from the National Institute of Health and Care Excellence or the Regional Medicines Optimisation Committee), should be made regarding arrangements for on-going prescribing of liothyronine. This should be for individuals who, in exceptional circumstances, have an on-going need for liothyronine as confirmed by a consultant NHS endocrinologist.