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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

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

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