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947566

	registered interest
	date	24/07/2018
	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 the advice provided by PresQIPP to Clinical Commissioning Groups is consistent with national guidelines on the prescription of Liothryonine (T3) to NHS patients.
	tabling member printed	Lord Hunt of Kings Heath
	uin	HL9848
	answer	answer is ministerial correction date of answer 26/07/2018 answer text <p>We have not made any assessment on the accuracy and advice provided by PrescQIPP. Nor have we made any assessment on whether the advice provided by PrescQIPP to clinical commissioning groups (CCGs) is consistent with national guidelines on the prescription of liothyronine to National Health Service patients. We can confirm that we have not received any assurances from PrescQIPP on whether or not it has taken patient stakeholder views into account as it is the responsibility of CCGs to seek any such assurances.</p><p>PrescQIPP is an independent social enterprise and it is for CCGs to decide whether and how they take that guidance into account when making decisions. However, NHS England expects CCGs to have due regard to the guidance <em>Items which should not routinely be prescribed in primary care: Guidance for CCGs,</em> published in November 2017 by NHS England and NHS Clinical Commissioners when considering the prescribing of liothyronine. A copy of the guidance is attached.</p> answering member printed Lord O'Shaughnessy grouped question UIN HL9847 HL9849 question first answered 26/07/2018 12:46:36 answering member 4545 label Biography information for Lord O'Shaughnessy attachment 1 file name items-which-should-not-be-routinely-precscribed-in-pc-ccg-guidance.pdf title Items which should not routinely be prescribed
	tabling member	2024 label Biography information for Lord Hunt of Kings Heath

931632

	registered interest
	date	26/06/2018
	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 action they propose to ensure that the Brighton and Sussex University Hospitals NHS Trust withdraws its policy of no longer making Liothyronine (T3) available to NHS patients, contrary to advice issued by NHS England which sets out the circumstances under which Liothyronine (T3) can be prescribed to new patients and continued for existing patients.
	tabling member printed	Lord Hunt of Kings Heath
	uin	HL8980
	answer	answer is ministerial correction date of answer 10/07/2018 answer text <p>The national guidelines advise clinical commissioning groups (CCGs) that local decisions should be made regarding arrangements for the on-going prescribing of liothyronine, taking into account the local needs of the population. While CCGs are expected to have regard to national guidance, they are entitled to develop their own local approaches to its implementation. During a debate on 20 June on the Branded Health Service Medicines (Costs) Regulations, I committed to pursuing further with NHS England ways in which they can clarify the guidelines on the prescribing of liothyronine to CCGs, including looking at whether greater clarity on the criteria for appropriate patient usage is merited.</p><p>The prescribing of Liothyronine (T3) was considered by the Sussex and East Surrey Sustainability and Transformation Partnership (STP) clinical board, which covers Brighton and Sussex University Hospitals, and High Weald, Lewes and Havens CCG, following engagement with primary care clinicians and endocrinologists. Based on the evidence presented, the decision not to routinely prescribe Liothyronine (T3) was supported across the STP region. It was, however, recognised that there would be some exceptions to this and that the use of the individual funding request triage process would be an appropriate mechanism to consider these.</p><p><strong> </strong></p> answering member printed Lord O'Shaughnessy grouped question UIN HL8981 HL8982 HL8983 question first answered 10/07/2018 15:41:18 answering member 4545 label Biography information for Lord O'Shaughnessy
	tabling member	2024 label Biography information for Lord Hunt of Kings Heath

931633

	registered interest
	date	26/06/2018
	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 action they propose to take to ensure that the High Weald, Lewes and Havens Clinical Commissioning Group withdraws its policy of no longer making Liothyronine (T3) available to NHS patients, contrary to advice issued by NHS England which sets out the circumstances under which Liothyronine (T3) can be prescribed to new patients and continued for existing patients.
	tabling member printed	Lord Hunt of Kings Heath
	uin	HL8981
	answer	answer is ministerial correction date of answer 10/07/2018 answer text <p>The national guidelines advise clinical commissioning groups (CCGs) that local decisions should be made regarding arrangements for the on-going prescribing of liothyronine, taking into account the local needs of the population. While CCGs are expected to have regard to national guidance, they are entitled to develop their own local approaches to its implementation. During a debate on 20 June on the Branded Health Service Medicines (Costs) Regulations, I committed to pursuing further with NHS England ways in which they can clarify the guidelines on the prescribing of liothyronine to CCGs, including looking at whether greater clarity on the criteria for appropriate patient usage is merited.</p><p>The prescribing of Liothyronine (T3) was considered by the Sussex and East Surrey Sustainability and Transformation Partnership (STP) clinical board, which covers Brighton and Sussex University Hospitals, and High Weald, Lewes and Havens CCG, following engagement with primary care clinicians and endocrinologists. Based on the evidence presented, the decision not to routinely prescribe Liothyronine (T3) was supported across the STP region. It was, however, recognised that there would be some exceptions to this and that the use of the individual funding request triage process would be an appropriate mechanism to consider these.</p><p><strong> </strong></p> answering member printed Lord O'Shaughnessy grouped question UIN HL8980 HL8982 HL8983 question first answered 10/07/2018 15:41:18 answering member 4545 label Biography information for Lord O'Shaughnessy
	tabling member	2024 label Biography information for Lord Hunt of Kings Heath

931634

	registered interest
	date	26/06/2018
	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 the Brighton and Sussex University Hospitals NHS Trust mistakenly stating that the only option for patients wishing to continue Liothyronine (T3) therapy is through the private sector, contrary to advice issued by NHS England which sets out the circumstances under which Liothyronine (T3) can be prescribed to new patients and continued for existing patients.
	tabling member printed	Lord Hunt of Kings Heath
	uin	HL8982
	answer	answer is ministerial correction date of answer 10/07/2018 answer text <p>The national guidelines advise clinical commissioning groups (CCGs) that local decisions should be made regarding arrangements for the on-going prescribing of liothyronine, taking into account the local needs of the population. While CCGs are expected to have regard to national guidance, they are entitled to develop their own local approaches to its implementation. During a debate on 20 June on the Branded Health Service Medicines (Costs) Regulations, I committed to pursuing further with NHS England ways in which they can clarify the guidelines on the prescribing of liothyronine to CCGs, including looking at whether greater clarity on the criteria for appropriate patient usage is merited.</p><p>The prescribing of Liothyronine (T3) was considered by the Sussex and East Surrey Sustainability and Transformation Partnership (STP) clinical board, which covers Brighton and Sussex University Hospitals, and High Weald, Lewes and Havens CCG, following engagement with primary care clinicians and endocrinologists. Based on the evidence presented, the decision not to routinely prescribe Liothyronine (T3) was supported across the STP region. It was, however, recognised that there would be some exceptions to this and that the use of the individual funding request triage process would be an appropriate mechanism to consider these.</p><p><strong> </strong></p> answering member printed Lord O'Shaughnessy grouped question UIN HL8980 HL8981 HL8983 question first answered 10/07/2018 15:41:18 answering member 4545 label Biography information for Lord O'Shaughnessy
	tabling member	2024 label Biography information for Lord Hunt of Kings Heath

931635

	registered interest
	date	26/06/2018
	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 action they propose to ensure that NHS bodies withdraw policies of no longer making Liothyronine (T3) available to NHS patients, contrary to advice issued by NHS England which sets out the circumstances under which Liothyronine (T3) can be prescribed to new patients and continued for existing patients.
	tabling member printed	Lord Hunt of Kings Heath
	uin	HL8983
	answer	answer is ministerial correction date of answer 10/07/2018 answer text <p>The national guidelines advise clinical commissioning groups (CCGs) that local decisions should be made regarding arrangements for the on-going prescribing of liothyronine, taking into account the local needs of the population. While CCGs are expected to have regard to national guidance, they are entitled to develop their own local approaches to its implementation. During a debate on 20 June on the Branded Health Service Medicines (Costs) Regulations, I committed to pursuing further with NHS England ways in which they can clarify the guidelines on the prescribing of liothyronine to CCGs, including looking at whether greater clarity on the criteria for appropriate patient usage is merited.</p><p>The prescribing of Liothyronine (T3) was considered by the Sussex and East Surrey Sustainability and Transformation Partnership (STP) clinical board, which covers Brighton and Sussex University Hospitals, and High Weald, Lewes and Havens CCG, following engagement with primary care clinicians and endocrinologists. Based on the evidence presented, the decision not to routinely prescribe Liothyronine (T3) was supported across the STP region. It was, however, recognised that there would be some exceptions to this and that the use of the individual funding request triage process would be an appropriate mechanism to consider these.</p><p><strong> </strong></p> answering member printed Lord O'Shaughnessy grouped question UIN HL8980 HL8981 HL8982 question first answered 10/07/2018 15:41:18 answering member 4545 label Biography information for Lord O'Shaughnessy
	tabling member	2024 label Biography information for Lord Hunt of Kings Heath

834485

	registered interest
	date	31/01/2018
	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 intend to commission research to evaluate the impact on patients of reduced access to liothyronine (T3) for the treatment of thyroid disease.
	tabling member printed	Lord Hunt of Kings Heath
	uin	HL5291
	answer	answer is ministerial correction date of answer 08/02/2018 answer text <p>We understand that whilst it is recognised that some patients on levothyroxine remain symptomatic despite treatment leading to thyroid stimulating hormone levels in the therapeutic range, it is not possible to predict the number as the reasons for this are not fully understood; such patients should be under the care of an endocrinologist. Where clinical commissioning groups decide to implement recommendations in NHS England’s guidance, they are responsible for deciding whether further action is required, such as commissioning research, to monitor uptake and outcomes.</p> answering member printed Lord O'Shaughnessy grouped question UIN HL5226 question first answered 08/02/2018 15:11:48 answering member 4545 label Biography information for Lord O'Shaughnessy
	tabling member	2024 label Biography information for Lord Hunt of Kings Heath

833608

	registered interest
	date	30/01/2018
	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 any Clinical Commissioning Groups refused to allow patients to be prescribed liothyronine (T3) before the consultation on Items which should not be routinely prescribed in primary care: Guidance for CCGs commenced; and if so, why.
	tabling member printed	Lord Hunt of Kings Heath
	uin	HL5228
	answer	answer is ministerial correction date of answer 08/02/2018 answer text <p>We understand that the British Thyroid Association (BTA) advises that a small proportion of patients treated with the most commonly used drug, levothyroxine, continue to suffer with symptoms despite adequate biochemical correction. In these circumstances, where levothyroxine has failed and in line with BTA guidance, endocrinologists providing NHS services may recommend liothyronine for individual patients after a carefully audited trial of at least three months’ duration of liothyronine.</p><p>NHS England’s recommendations to clinical commissioning groups (CCGs) take account of those of the BTA and are to:</p><p>- Advise CCGs that prescribers in primary care should not initiate liothyronine for any new patient;</p><p> </p><p>- Advise CCGs that individuals currently prescribed liothyronine should be reviewed by a consultant NHS endocrinologist with consideration given to switching to levothyroxine where clinically appropriate; and</p><p> </p><p>- Advise CCGs that a local decision, involving the Area Prescribing Committee (or equivalent) informed by national guidance (e.g. from the National Institute for 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 National Health Service endocrinologist.</p><p>A number of CCGs had already created local policies on the prescribing of liothryronine before the national consultation started in July 2017.</p> answering member printed Lord O'Shaughnessy grouped question UIN HL5225 question first answered 08/02/2018 15:03:07 answering member 4545 label Biography information for Lord O'Shaughnessy
	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

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

1049579

	registered interest
	date	28/01/2019
	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 discussions they have had, or intend to have, with NHS England on ensuring Liothyronine (T3) is prescribed in accordance with NICE guidelines.
	tabling member printed	Lord Hunt of Kings Heath
	uin	HL13166
	answer	answer is ministerial correction date of answer 11/02/2019 answer text <p>The Department has had no such discussions with NHS England on ensuring liothyronine is prescribed in accordance with the National Institute for Health and Care Excellence guidelines, nor does the Department intend to conduct such an assessment.</p><p>The Regional Medicines Optimising Committee published its latest guidance on the prescribing of liothyronine in November and we can confirm NHS England is working closely with clinical commissioning groups (CCGs) on the prescribing of liothyronine to support them with the implementation of guidance for CCGs on items which should not be routinely prescribed in primary care.</p><p>CCGs are expected to have regard to national guidance, and are responsible for developing their own local approaches to its implementation taking into account local priorities and needs.</p> answering member printed Baroness Blackwood of North Oxford grouped question UIN HL13167 question first answered 11/02/2019 17:39:28 answering member 4019 label Biography information for Baroness Blackwood of North Oxford
	tabling member	2024 label Biography information for Lord Hunt of Kings Heath

1049580

	registered interest
	date	28/01/2019
	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 intend to conduct an assessment of the impact of the withdrawal of Liothyronine (T3) on patients as a result of Clinical Commissioning Groups misinterpreting or failing to follow NHS England's guidance on the prescription of that drug.
	tabling member printed	Lord Hunt of Kings Heath
	uin	HL13167
	answer	answer is ministerial correction date of answer 11/02/2019 answer text <p>The Department has had no such discussions with NHS England on ensuring liothyronine is prescribed in accordance with the National Institute for Health and Care Excellence guidelines, nor does the Department intend to conduct such an assessment.</p><p>The Regional Medicines Optimising Committee published its latest guidance on the prescribing of liothyronine in November and we can confirm NHS England is working closely with clinical commissioning groups (CCGs) on the prescribing of liothyronine to support them with the implementation of guidance for CCGs on items which should not be routinely prescribed in primary care.</p><p>CCGs are expected to have regard to national guidance, and are responsible for developing their own local approaches to its implementation taking into account local priorities and needs.</p> answering member printed Baroness Blackwood of North Oxford grouped question UIN HL13166 question first answered 11/02/2019 17:39:28 answering member 4019 label Biography information for Baroness Blackwood of North Oxford
	tabling member	2024 label Biography information for Lord Hunt of Kings Heath

1041211

	registered interest
	date	14/01/2019
	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 discussions they have had with NHS England about the ability for doctors to follow the advice given on the prescription of liothyronine (T3) when bans on its prescription have been put in place at a local level.
	tabling member printed	Lord Hunt of Kings Heath
	uin	HL12793
	answer	answer is ministerial correction date of answer 22/01/2019 answer text <p>NHS England is working closely with clinical commissioning groups (CCGs) on the prescribing of liothyronine to support them with the implementation of guidance for CCGs on items which should not be routinely prescribed in primary care. The Department has not had specific discussions with NHS England or made an assessment on these issues.</p><p>CCGs are expected to have regard to national guidance, and are responsible for developing their own local approaches to its implementation taking into account local priorities and needs. CCGs set the policy which governs what hospitals and trusts implement, therefore the prescription of liothyronine at University Hospital Bristol and Musgrove Park Hospital in Taunton is a matter for those CCGs.</p><p>This guidance for CCGs on items which should not be routinely prescribed in primary care includes recommendations on the use of liothyronine in line with the British Thyroid Association, who advise that a small proportion of patients treated with levothyroxine continue to suffer with symptoms despite adequate biochemical correction. In these circumstances,</p><p>where levothyroxine has failed and in line with this guidance, endocrinologists providing NHS services may recommend liothyronine for individual patients after a carefully audited trial of at least three months duration of the drug.</p><p>Further guidance on the prescribing of liothyronine has been published by the Regional Medicines Optimisation Committee. The aim of the guidance is to make best practice on the prescribing of liothyronine clearer. A copy of <em>Guidance – Prescribing of Liothyronine</em> is attached.</p> answering member printed Baroness Manzoor grouped question UIN HL12791 HL12792 HL12794 question first answered 22/01/2019 16:17:24 answering member 4289 label Biography information for Baroness Manzoor attachment 1 file name RMOC-Liothyronine-Guidance-v2.0-final-1.pdf title RMOC liothyronine guidance
	tabling member	2024 label Biography information for Lord Hunt of Kings Heath

1041212

	registered interest
	date	14/01/2019
	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 the barriers in place to the prescription of liothyronine (T3) in England, if any; and what steps they plan to take to overcome any such barriers.
	tabling member printed	Lord Hunt of Kings Heath
	uin	HL12794
	answer	answer is ministerial correction date of answer 22/01/2019 answer text <p>NHS England is working closely with clinical commissioning groups (CCGs) on the prescribing of liothyronine to support them with the implementation of guidance for CCGs on items which should not be routinely prescribed in primary care. The Department has not had specific discussions with NHS England or made an assessment on these issues.</p><p>CCGs are expected to have regard to national guidance, and are responsible for developing their own local approaches to its implementation taking into account local priorities and needs. CCGs set the policy which governs what hospitals and trusts implement, therefore the prescription of liothyronine at University Hospital Bristol and Musgrove Park Hospital in Taunton is a matter for those CCGs.</p><p>This guidance for CCGs on items which should not be routinely prescribed in primary care includes recommendations on the use of liothyronine in line with the British Thyroid Association, who advise that a small proportion of patients treated with levothyroxine continue to suffer with symptoms despite adequate biochemical correction. In these circumstances,</p><p>where levothyroxine has failed and in line with this guidance, endocrinologists providing NHS services may recommend liothyronine for individual patients after a carefully audited trial of at least three months duration of the drug.</p><p>Further guidance on the prescribing of liothyronine has been published by the Regional Medicines Optimisation Committee. The aim of the guidance is to make best practice on the prescribing of liothyronine clearer. A copy of <em>Guidance – Prescribing of Liothyronine</em> is attached.</p> answering member printed Baroness Manzoor grouped question UIN HL12791 HL12792 HL12793 question first answered 22/01/2019 16:17:24 answering member 4289 label Biography information for Baroness Manzoor attachment 1 file name RMOC-Liothyronine-Guidance-v2.0-final-1.pdf title RMOC liothyronine guidance
	tabling member	2024 label Biography information for Lord Hunt of Kings Heath

1025353

	registered interest
	date	14/12/2018
	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 action they are taking to negotiate a reduction of the cost of liothyronine (T3) for use in primary care.
	tabling member printed	Lord Hunt of Kings Heath
	uin	HL12319
	answer	answer is ministerial correction date of answer 20/12/2018 answer text <p>Liothyronine is an unbranded generic medicine. The Department encourages competition between suppliers of unbranded generic medicines to keep prices down. This generally works well and has led to some of the lowest prices in Europe.</p><p>Concerns about anti-competitive behaviour are a matter for the Competition and Markets Authority (CMA) to investigate. Liothyronine, marketed by Concordia, is currently the subject of an investigation by the CMA, which has provisionally found that Concordia abused its dominant position to overcharge the National Health Service by millions 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.</p><p>The Department also has its own powers to limit prices of unbranded generic medicines and will consult early in 2019 with the relevant industry bodies on implementation of those powers.</p> answering member printed Lord O'Shaughnessy question first answered 20/12/2018 15:44:26 answering member 4545 label Biography information for Lord O'Shaughnessy
	tabling member	2024 label Biography information for Lord Hunt of Kings Heath

1049581

	registered interest
	date	28/01/2019
	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 they are taking to ensure that Liothyronine (T3) is purchased at a cost in line with other EU countries.
	tabling member printed	Lord Hunt of Kings Heath
	uin	HL13168
	answer	answer is ministerial correction date of answer 11/02/2019 answer text <p>All United Kingdom marketing authorisation holders of liothyronine are obliged to ensure that the product complies with the minimum standard as specified in the updated British Pharmacopoeia monograph for liothyronine tablets. Liothyronine on the market in other European Union Member States may not comply with the updated British Pharmacopoeia monograph and therefore would not be considered therapeutically equivalent.</p><p>Liothyronine is an unbranded generic medicine. The Department encourages competition between suppliers of unbranded generic medicines to keep prices down. This generally works well and has led to some of the lowest prices in Europe. Concerns about anti-competitive behaviour are a matter for the Competition and Markets Authority (CMA) to investigate.</p><p>Liothyronine, marketed by Advanz Pharma (formerly Concordia), is currently the subject of an investigation by the CMA. The CMA has provisionally found that the company abused its dominant position to overcharge the National Health Service 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.</p> answering member printed Baroness Blackwood of North Oxford question first answered 11/02/2019 13:48:58 answering member 4019 label Biography information for Baroness Blackwood of North Oxford
	tabling member	2024 label Biography information for Lord Hunt of Kings Heath

1060919

	registered interest
	date	13/02/2019
	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 they will take to prevent any harm to thyroid patients who require liothyronine and who are unable to secure funding for such treatment by Clinical Commissioning Groups because of the cost of this medicine set by the three UK licence holders.
	tabling member printed	Lord Hunt of Kings Heath
	uin	HL13695
	answer	answer is ministerial correction date of answer 27/02/2019 answer text <p>Guidance on the prescribing of liothyronine has been published by the Regional Medicines Optimisation Committee (RMOC). A copy of Guidance – Prescribing of Liothyronine is attached. The aim of the guidance is to make best practice on the prescribing of liothyronine clearer. This guidance provides advice on the prescribing of liothyronine and on the review of National Health Service patients who are being prescribed liothyronine. The guidance supports clinical commissioning groups (CCGs) and Area Prescribing Committees in local decision making and enables a consistent approach for the exceptional circumstances in which patients have an ongoing need for liothyronine.</p><p>The guidance states that “As specified by the British Thyroid Association Executive Committee, clinicians have an ethical responsibility to adhere to the highest professional standards of good medical practice rooted in sound evidence. This includes not prescribing potentially harmful therapies without proven advantages over existing treatments’. The RMOC therefore recommends that strict criteria are applied to ensure that liothyronine is only prescribed in the very rare situations where alternative treatments have been found to be inadequate. In such circumstances, an ongoing shared care arrangement may be appropriate if agreed by local commissioners. If a patient is ever initiated on treatment, prescribing responsibility should remain with the hospital consultant for at least 3 months”.</p><p>CCG are expected to have regard to national guidance, and are responsible for developing their own local approaches to its implementation taking into account local priorities and needs.</p><p>Any patient who feels they have suffered harm as a result of NHS treatment may raise the matter, in writing, electronically, or orally, with the service provider, or with the commissioner of the service. If local resolution is unsuccessful, the person making the complaint has the right to refer their complaint to the Health Service Ombudsman.</p> answering member printed Baroness Blackwood of North Oxford question first answered 27/02/2019 13:17:31 answering member 4019 label Biography information for Baroness Blackwood of North Oxford attachment 1 file name RMOC-Liothyronine-Guidance-v2.0-final-1.pdf title HL13695 attached document
	tabling member	2024 label Biography information for Lord Hunt of Kings Heath

1156575

	registered interest
	date	28/10/2019
	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 action they are taking to ensure that the updated prescribing guidance for liothyronine issued by the South Regional Medicines Optimisation Committee in July is followed by all Clinical Commissioning Groups.
	tabling member printed	Lord Hunt of Kings Heath
	uin	HL455
	answer	answer is ministerial correction date of answer 04/11/2019 answer text <p>It is not the responsibility of the Department to direct clinical commissioning groups (CCGs) on which medicines they can or cannot prescribe. These decisions need to be taken by each individual CCG. However, we would expect CCGs to have regard to the South Regional Medicines Optimisation Committee prescribing guidance.</p> answering member printed Baroness Blackwood of North Oxford question first answered 04/11/2019 14:51:03 answering member 4019 label Biography information for Baroness Blackwood of North Oxford
	tabling member	2024 label Biography information for Lord Hunt of Kings Heath

1156576

	registered interest
	date	28/10/2019
	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 action they propose to take in relation to thyroid patients who, having previously had successful treatment on dosages of 20mcg and above of liothyronine, are now facing a restriction on the dosage.
	tabling member printed	Lord Hunt of Kings Heath
	uin	HL456
	answer	answer is ministerial correction date of answer 04/11/2019 answer text <p>Whilst NHS England and NHS Improvement will regularly review its guidance, at present, there are no plans to revisit the specific recommendations for liothyronine unless new clinical evidence comes to light. Decisions on appropriate treatment for thyroid patients and doses are taken in accordance with a clinical management plan and implemented by the clinician.</p> answering member printed Baroness Blackwood of North Oxford question first answered 04/11/2019 14:53:13 answering member 4019 label Biography information for Baroness Blackwood of North Oxford
	tabling member	2024 label Biography information for Lord Hunt of Kings Heath

1156579

	registered interest
	date	28/10/2019
	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 how many Individual Funding Requests have been received for treatment with liothyronine since the start of the Low Priority Prescribing Project Programme in 2017.
	tabling member printed	Lord Hunt of Kings Heath
	uin	HL459
	answer	answer is ministerial correction date of answer 05/11/2019 answer text <p>NHS England has advised that treatment with liothyronine is commissioned by clinical commissioning groups and that it does not collate information on Individual Funding Requests centrally.</p> answering member printed Baroness Blackwood of North Oxford question first answered 05/11/2019 13:08:19 answering member 4019 label Biography information for Baroness Blackwood of North Oxford
	tabling member	2024 label Biography information for Lord Hunt of Kings Heath

1167235

	registered interest
	date	29/10/2019
	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 price to the NHS liothyronine would need to fall below in order for the restriction on its prescription to be lifted.
	tabling member printed	Lord Hunt of Kings Heath
	uin	HL503
	answer	answer is ministerial correction date of answer 04/11/2019 answer text <p>The Department would not intervene in determining what price to the National Health Service liothyronine would need to fall below in order for the restriction on its prescription to be lifted.</p><p>Liothyronine is only appropriate for a certain group of patients and the South Regional Medicines Optimisation Committee advice sought to provide further clinical guidance on this matter. Whilst NHS England and NHS Improvement will regularly review its guidance, at present, there are no plans to revisit the specific recommendations for liothyronine unless new clinical evidence comes to light.</p> answering member printed Baroness Blackwood of North Oxford question first answered 04/11/2019 14:53:28 answering member 4019 label Biography information for Baroness Blackwood of North Oxford
	tabling member	2024 label Biography information for Lord Hunt of Kings Heath

1176607

	registered interest
	date	05/02/2020
	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 the operation of data protection legislation in respect of Clinical Commissioning Groups asking to see patients' personal health data when reviewing the use of liothyronine for the purposes of cost cutting.
	tabling member printed	Lord Hunt of Kings Heath
	uin	HL1359
	answer	answer is ministerial correction date of answer 12/02/2020 answer text <p>Clinical commissioning groups (CCGs) are legally responsible, as data controllers in their own right, to abide by data protection legislation when processing any data. The Department does not assess their operation of data protection legislation.</p><p>CCGs are the responsible commissioner for the prescription of liothyronine and it is for CCGs to have regard to guidance set out by the National Institute for Health and Care Excellence (NICE) and NHS England and NHS Improvement.</p> answering member printed Baroness Blackwood of North Oxford question first answered 12/02/2020 17:41:55 answering member 4019 label Biography information for Baroness Blackwood of North Oxford
	tabling member	2024 label Biography information for Lord Hunt of Kings Heath

1178126

	registered interest
	date	12/02/2020
	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 the report T3 Prescribing Survey Report, published on 7 February; and in particular the reported failure by Clinical Commissioning Groups to follow NHS England’s Regional Medicines Optimisation Committee’s revised Guidance–Prescribing of Liothyronine, published in July 2019.
	tabling member printed	Lord Hunt of Kings Heath
	uin	HL1581
	answer	answer is ministerial correction date of answer 24/02/2020 answer text <p>We have made no such assessment.</p><p>NHS England and NHS Improvement along with NHS Clinical Commissioners’ latest guidance for clinical commissioning groups, taking into account comments from the British Thyroid Association, was published in June 2019. The National Institute for Health and Care Excellence also published guidelines in November 2019 stating that liothyronine should not be offered routinely for primary hypothyroidism, either alone, or in combination with levothyroxine.</p><p>Representatives of NHS England and NHS Improvement and NHS Clinical Commissioners met with representatives from the Thyroid Trust, Healthwatch England, Lord Hunt of Kings Heath and Lord Borwick of Hawkshead on 13 February 2020. NHS England and NHS Improvement will clarify guidance within the National Health Service system. This guidance will set out that the recommendation of the clinical working group was that liothyronine should not be routinely prescribed in primary care; but there may be circumstances where prescribing of the medication is clinically appropriate for individual patients as determined by endocrinologists providing NHS services, after a carefully audited trial of at least three months duration of the medicine.</p> answering member printed Lord Bethell question first answered 24/02/2020 12:06:03 answering member 4708 label Biography information for Lord Bethell
	tabling member	2024 label Biography information for Lord Hunt of Kings Heath