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1581667

registered interest
date	30/01/2023
answering body	Department of Health and Social Care
answering dept id	17
answering dept short name	Health and Social Care
answering dept sort name	Health and Social Care
hansard heading	Liothyronine
house id	2
legislature	25277 pref label House of Lords
question text	To ask His Majesty's Government what cost assessment they have undertaken of the daily dose rationing of liothyronine regardless of clinical need by the (1) NHS Devon, (2) NHS Buckinghamshire, and (3) NHS Hertfordshire, Integrated Care Boards; and what comparative assessment they have made of (a) the NHS England national guidance, and (b) the National Institute for Health and Care Excellence British National Formulary guidance on liothyronine, given the risk of harm to patients and that smaller doses lead to higher costs.
tabling member printed	Lord Hunt of Kings Heath
uin	HL5206
answer	answer is ministerial correction date of answer 09/02/2023 answer text <p>No assessments have been made.</p> answering member printed Lord Markham question first answered 09/02/2023 12:17:34 answering member 4948 label Biography information for Lord Markham
tabling member	2024 label Biography information for Lord Hunt of Kings Heath

1361539

registered interest
date	19/10/2021
answering body	Department of Health and Social Care
answering dept id	17
answering dept short name	Health and Social Care
answering dept sort name	Health and Social Care
hansard heading	Liothyronine
house id	2
legislature	25277 pref label House of Lords
question text	To ask Her Majesty's Government what steps NHS Clinical Commissioners took to communicate national guidance for the prescribing of liothyronine to local NHS bodies; and whether that guidance says that liothyronine may only be prescribed when recommended by a specialist after treatment using levothyroxine has failed.
tabling member printed	Lord Hunt of Kings Heath
uin	HL3197
answer	answer is ministerial correction date of answer 29/10/2021 answer text <p>National Health Service clinical commissioners have promoted national guidance through their bulletins with clinical commissioning groups members. National guidance recommends that in circumstances where levothyroxine has failed, endocrinologists providing NHS services may recommend liothyronine for individual patients after a carefully audited trial of liothyronine for at least three months duration.</p><p>We have made no assessment on whether liothyronine should be de-classified as a high cost medicine. To date, NHS England NHS Improvement have not conducted any specific assessments on liothyronine following the Competition and Markets Authority ruling. This will be considered as part of any formal review to national guidance.</p> answering member printed Lord Kamall grouped question UIN HL3198 question first answered 29/10/2021 09:52:10 answering member 4909 label Biography information for Lord Kamall
tabling member	2024 label Biography information for Lord Hunt of Kings Heath

1361540

registered interest
date	19/10/2021
answering body	Department of Health and Social Care
answering dept id	17
answering dept short name	Health and Social Care
answering dept sort name	Health and Social Care
hansard heading	Liothyronine
house id	2
legislature	25277 pref label House of Lords
question text	To ask Her Majesty's Government what assessment they have made of whether liothyronine should be declassified as a high-cost medicine following the Competition and Markets Authority ruling and fine issued to Advanz for artificially inflating the price of thyroid tablets.
tabling member printed	Lord Hunt of Kings Heath
uin	HL3198
answer	answer is ministerial correction date of answer 29/10/2021 answer text <p>National Health Service clinical commissioners have promoted national guidance through their bulletins with clinical commissioning groups members. National guidance recommends that in circumstances where levothyroxine has failed, endocrinologists providing NHS services may recommend liothyronine for individual patients after a carefully audited trial of liothyronine for at least three months duration.</p><p>We have made no assessment on whether liothyronine should be de-classified as a high cost medicine. To date, NHS England NHS Improvement have not conducted any specific assessments on liothyronine following the Competition and Markets Authority ruling. This will be considered as part of any formal review to national guidance.</p> answering member printed Lord Kamall grouped question UIN HL3197 question first answered 29/10/2021 09:52:10 answering member 4909 label Biography information for Lord Kamall
tabling member	2024 label Biography information for Lord Hunt of Kings Heath

1361541

registered interest
date	19/10/2021
answering body	Department of Health and Social Care
answering dept id	17
answering dept short name	Health and Social Care
answering dept sort name	Health and Social Care
hansard heading	Liothyronine
house id	2
legislature	25277 pref label House of Lords
question text	To ask Her Majesty's Government whether they will conduct a review of (1) the actions of NHS England, and (2) the impact on patients with thyroid conditions, following the Competition and Markets Authority’s ruling and fine issued to Advanz for artificially inflating the price of thyroid tablets.
tabling member printed	Lord Hunt of Kings Heath
uin	HL3199
answer	answer is ministerial correction date of answer 29/10/2021 answer text <p>We have no plans to do so. NHS England and NHS Improvement’s guidance Items which should not routinely be prescribed in primary care: Guidance for CCGs identifies items which are clinically effective but where more cost-effective products are available. This includes liothyronine and other products that have been subject to excessive price inflation.</p><p>The guidance states that there are three categories for such items which are as follows:</p><p>- Products of low clinical effectiveness, where there is a lack of robust evidence of clinical effectiveness or there are significant safety concerns;</p><p>- Products which are clinically effective but where more cost-effective products are available, including some products that have been subject to excessive price inflation; and</p><p>- Products which are clinically effective but due to the nature of the product are deemed a low priority for National Health Service funding.</p><p> </p><p>Liothyronine was included in the second category. Additionally, it was noted that there was limited evidence to support its routine prescribing in preference to levothyroxine. A copy of this guidance is attached. NHS England and NHS Improvement will review the guidance on a regular basis to ensure that any updated evidence on clinical and cost effectiveness is considered.</p> answering member printed Lord Kamall question first answered 29/10/2021 09:55:14 answering member 4909 label Biography information for Lord Kamall attachment 1 file name HL3199 - Attachment 2.pdf title Items which should not routinely be prescribed in
tabling member	2024 label Biography information for Lord Hunt of Kings Heath

1360890

registered interest
date	18/10/2021
answering body	Department of Health and Social Care
answering dept id	17
answering dept short name	Health and Social Care
answering dept sort name	Health and Social Care
hansard heading	Liothyronine
house id	2
legislature	25277 pref label House of Lords
question text	To ask Her Majesty's Government, further to the Written Answer by Lord Bethell on 17 March (HL14040), what assessment they have made as to whether the fall in the price of Liothyronine (T3) is related to increased competition from marketing authorisations granted since 2016.
tabling member printed	Lord Hunt of Kings Heath
uin	HL3158
answer	answer is ministerial correction date of answer 22/10/2021 answer text <p>We have made no further assessment of the price of Liothyronine relative to increased competition from marketing authorisations or the cost of medicines in other parts of Europe. Further marketing authorisation applications remain at the discretion of pharmaceutical companies.</p> answering member printed Lord Kamall grouped question UIN HL3159 HL3160 question first answered 22/10/2021 10:19:03 answering member 4909 label Biography information for Lord Kamall
tabling member	2024 label Biography information for Lord Hunt of Kings Heath

1360891

registered interest
date	18/10/2021
answering body	Department of Health and Social Care
answering dept id	17
answering dept short name	Health and Social Care
answering dept sort name	Health and Social Care
hansard heading	Liothyronine
house id	2
legislature	25277 pref label House of Lords
question text	To ask Her Majesty's Government, further to the Written Answer by Lord Bethell on 17 March (HL14040), what plans they have to encourage further marketing authorisations for Liothyronine (T3).
tabling member printed	Lord Hunt of Kings Heath
uin	HL3159
answer	answer is ministerial correction date of answer 22/10/2021 answer text <p>We have made no further assessment of the price of Liothyronine relative to increased competition from marketing authorisations or the cost of medicines in other parts of Europe. Further marketing authorisation applications remain at the discretion of pharmaceutical companies.</p> answering member printed Lord Kamall grouped question UIN HL3158 HL3160 question first answered 22/10/2021 10:19:03 answering member 4909 label Biography information for Lord Kamall
tabling member	2024 label Biography information for Lord Hunt of Kings Heath

1360892

registered interest
date	18/10/2021
answering body	Department of Health and Social Care
answering dept id	17
answering dept short name	Health and Social Care
answering dept sort name	Health and Social Care
hansard heading	Liothyronine
house id	2
legislature	25277 pref label House of Lords
question text	To ask Her Majesty's Government, further to the Written Answer by Lord Bethell on 17 March (HL14040), what assessment they have made of the reduction in cost of Liothyronine (T3) in the UK, compared to the cost of the medication in other parts of Europe.
tabling member printed	Lord Hunt of Kings Heath
uin	HL3160
answer	answer is ministerial correction date of answer 22/10/2021 answer text <p>We have made no further assessment of the price of Liothyronine relative to increased competition from marketing authorisations or the cost of medicines in other parts of Europe. Further marketing authorisation applications remain at the discretion of pharmaceutical companies.</p> answering member printed Lord Kamall grouped question UIN HL3158 HL3159 question first answered 22/10/2021 10:19:03 answering member 4909 label Biography information for Lord Kamall
tabling member	2024 label Biography information for Lord Hunt of Kings Heath

1356034

registered interest
date	15/09/2021
answering body	Department of Health and Social Care
answering dept id	17
answering dept short name	Health and Social Care
answering dept sort name	Health and Social Care
hansard heading	Liothyronine
house id	2
legislature	25277 pref label House of Lords
question text	To ask Her Majesty's Government, further to the finding by the Competition and Markets Authority that drug companies had over-charged the National Health Service, what plans they have to reduce the price that the National Health Service pays for liothyronine.
tabling member printed	Lord Hunt of Kings Heath
uin	HL2744
answer	answer is ministerial correction date of answer 29/09/2021 answer text <p>Since 2016, several marketing authorisations have been granted for liothyronine, therefore the National Health Service reimbursement price in primary care has been reducing as a direct response to more competition in the market.</p> answering member printed Lord Kamall question first answered 29/09/2021 15:39:55 answering member 4909 label Biography information for Lord Kamall
tabling member	2024 label Biography information for Lord Hunt of Kings Heath

1301011

registered interest
date	09/03/2021
answering body	Department of Health and Social Care
answering dept id	17
answering dept short name	Health and Social Care
answering dept sort name	Health and Social Care
hansard heading	Liothyronine
house id	2
legislature	25277 pref label House of Lords
question text	To ask Her Majesty's Government, further to the Written Answer by Lord Bethell on 4 March (HL13668), what comparison they have made of the cost of Liothyronine (T3) in (1) the UK, and (2) EU member states; and what assessment they have made of any such comparison.
tabling member printed	Lord Hunt of Kings Heath
uin	HL14040
answer	answer is ministerial correction date of answer 17/03/2021 answer text <p>The Department has made no such comparison or assessment. All United Kingdom marketing authorisation holders of liothyronine are obliged to ensure that the product complies with the minimum standard as specified in the British Pharmacopoeia monograph for liothyronine tablets. Liothyronine on the market in European Union Member States may not comply with the updated British Pharmacopoeia monograph and therefore would not be considered therapeutically equivalent. Therefore, price comparisons would not be ‘like for like’.</p><p>In the UK, several marketing authorisations have been granted for liothyronine since 2016 and the reimbursement price has slowly been reducing as a direct response to more competition in the market.</p> answering member printed Lord Bethell question first answered 17/03/2021 16:37:23 answering member 4708 label Biography information for Lord Bethell
tabling member	2024 label Biography information for Lord Hunt of Kings Heath

1289365

registered interest
date	24/02/2021
answering body	Department of Health and Social Care
answering dept id	17
answering dept short name	Health and Social Care
answering dept sort name	Health and Social Care
hansard heading	Liothyronine
house id	2
legislature	25277 pref label House of Lords
question text	To ask Her Majesty's Government, further to the Written Answer by Lord Bethell on 17 February (HL13177), whether an intervention under the Health Service Medical Supplies (Costs) Act 2017 has taken place to control the cost of Liothyronine (T3); and if not, why not.
tabling member printed	Lord Hunt of Kings Heath
uin	HL13668
answer	answer is ministerial correction date of answer 04/03/2021 answer text <p>No such intervention has taken place. Several marketing authorisations have been granted for liothyronine since 2016 and the reimbursement price has been reducing as a direct response to more competition in the market.</p> answering member printed Lord Bethell question first answered 04/03/2021 12:36:50 answering member 4708 label Biography information for Lord Bethell
tabling member	2024 label Biography information for Lord Hunt of Kings Heath