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>
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>
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>"} , "answeringMember" : {"_about" : "http://data.parliament.uk/members/4019", "label" : {"_value" : "Biography information for Baroness Blackwood of North Oxford"} } , "answeringMemberPrinted" : {"_value" : "Baroness Blackwood of North Oxford"} , "dateOfAnswer" : {"_value" : "2019-02-11", "_datatype" : "dateTime"} , "isMinisterialCorrection" : {"_value" : "false", "_datatype" : "boolean"} , "questionFirstAnswered" : [{"_value" : "2019-02-11T13:48:58.55Z", "_datatype" : "dateTime"} ]} , "answeringDeptId" : {"_value" : "17"} , "answeringDeptShortName" : {"_value" : "Health and Social Care"} , "answeringDeptSortName" : {"_value" : "Health and Social Care"} , "date" : {"_value" : "2019-01-28", "_datatype" : "dateTime"} , "hansardHeading" : {"_value" : "Liothyronine"} , "houseId" : {"_value" : "2"} , "legislature" : [{"_about" : "http://data.parliament.uk/terms/25277", "prefLabel" : {"_value" : "House of Lords"} } ], "questionText" : "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.", "registeredInterest" : {"_value" : "false", "_datatype" : "boolean"} , "tablingMember" : {"_about" : "http://data.parliament.uk/members/2024", "label" : {"_value" : "Biography information for Lord Hunt of Kings Heath"} } , "tablingMemberPrinted" : [{"_value" : "Lord Hunt of Kings Heath"} ], "uin" : "HL13168"} , {"_about" : "http://data.parliament.uk/resources/1041209", "AnsweringBody" : [{"_value" : "Department of Health and Social Care"} ], "answer" : {"_about" : "http://data.parliament.uk/resources/1041209/answer", "answerText" : {"_value" : "
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>
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>
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>
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>
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 Guidance \u2013 Prescribing of Liothyronine<\/em> is attached.<\/p>"}
, "answeringMember" : {"_about" : "http://data.parliament.uk/members/4289", "label" : {"_value" : "Biography information for Baroness Manzoor"}
}
, "answeringMemberPrinted" : {"_value" : "Baroness Manzoor"}
, "attachment" : {"_about" : "http://data.parliament.uk/resources/1041209/answer/attachment/1", "fileName" : {"_value" : "RMOC-Liothyronine-Guidance-v2.0-final-1.pdf"}
, "title" : "RMOC liothyronine guidance"}
, "dateOfAnswer" : {"_value" : "2019-01-22", "_datatype" : "dateTime"}
, "groupedQuestionUIN" : [{"_value" : "HL12792"}
, {"_value" : "HL12793"}
, {"_value" : "HL12794"}
], "isMinisterialCorrection" : {"_value" : "false", "_datatype" : "boolean"}
, "questionFirstAnswered" : [{"_value" : "2019-01-22T16:17:24.337Z", "_datatype" : "dateTime"}
]}
, "answeringDeptId" : {"_value" : "17"}
, "answeringDeptShortName" : {"_value" : "Health and Social Care"}
, "answeringDeptSortName" : {"_value" : "Health and Social Care"}
, "date" : {"_value" : "2019-01-14", "_datatype" : "dateTime"}
, "hansardHeading" : {"_value" : "University Hospitals Bristol NHS Foundation Trust: Liothyronine"}
, "houseId" : {"_value" : "2"}
, "legislature" : [{"_about" : "http://data.parliament.uk/terms/25277", "prefLabel" : {"_value" : "House of Lords"}
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], "questionText" : "To ask Her Majesty's Government what action they plan to take to lift the ban on the prescription of liothyronine (T3) by University Hospital Bristol in contradiction of the advice given by NHS England.", "registeredInterest" : {"_value" : "false", "_datatype" : "boolean"}
, "tablingMember" : {"_about" : "http://data.parliament.uk/members/2024", "label" : {"_value" : "Biography information for Lord Hunt of Kings Heath"}
}
, "tablingMemberPrinted" : [{"_value" : "Lord Hunt of Kings Heath"}
], "uin" : "HL12791"}
, {"_about" : "http://data.parliament.uk/resources/1041210", "AnsweringBody" : [{"_value" : "Department of Health and Social Care"}
], "answer" : {"_about" : "http://data.parliament.uk/resources/1041210/answer", "answerText" : {"_value" : " 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> 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> 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> 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> 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 Guidance \u2013 Prescribing of Liothyronine<\/em> is attached.<\/p>"}
, "answeringMember" : {"_about" : "http://data.parliament.uk/members/4289", "label" : {"_value" : "Biography information for Baroness Manzoor"}
}
, "answeringMemberPrinted" : {"_value" : "Baroness Manzoor"}
, "attachment" : {"_about" : "http://data.parliament.uk/resources/1041210/answer/attachment/1", "fileName" : {"_value" : "RMOC-Liothyronine-Guidance-v2.0-final-1.pdf"}
, "title" : "RMOC liothyronine guidance"}
, "dateOfAnswer" : {"_value" : "2019-01-22", "_datatype" : "dateTime"}
, "groupedQuestionUIN" : [{"_value" : "HL12791"}
, {"_value" : "HL12793"}
, {"_value" : "HL12794"}
], "isMinisterialCorrection" : {"_value" : "false", "_datatype" : "boolean"}
, "questionFirstAnswered" : [{"_value" : "2019-01-22T16:17:24.39Z", "_datatype" : "dateTime"}
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, "answeringDeptId" : {"_value" : "17"}
, "answeringDeptShortName" : {"_value" : "Health and Social Care"}
, "answeringDeptSortName" : {"_value" : "Health and Social Care"}
, "date" : {"_value" : "2019-01-14", "_datatype" : "dateTime"}
, "hansardHeading" : {"_value" : "Musgrove Park Hospital: Liothyronine"}
, "houseId" : {"_value" : "2"}
, "legislature" : [{"_about" : "http://data.parliament.uk/terms/25277", "prefLabel" : {"_value" : "House of Lords"}
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], "questionText" : "To ask Her Majesty's Government what action they plan to take to change the approach to the prescription of liothyronine (T3) being taken by Musgrove Hospital, Taunton which is in contradiction of the advice given by NHS England.", "registeredInterest" : {"_value" : "false", "_datatype" : "boolean"}
, "tablingMember" : {"_about" : "http://data.parliament.uk/members/2024", "label" : {"_value" : "Biography information for Lord Hunt of Kings Heath"}
}
, "tablingMemberPrinted" : [{"_value" : "Lord Hunt of Kings Heath"}
], "uin" : "HL12792"}
, {"_about" : "http://data.parliament.uk/resources/1041211", "AnsweringBody" : [{"_value" : "Department of Health and Social Care"}
], "answer" : {"_about" : "http://data.parliament.uk/resources/1041211/answer", "answerText" : {"_value" : " 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> 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> 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> 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> 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 Guidance \u2013 Prescribing of Liothyronine<\/em> is attached.<\/p>"}
, "answeringMember" : {"_about" : "http://data.parliament.uk/members/4289", "label" : {"_value" : "Biography information for Baroness Manzoor"}
}
, "answeringMemberPrinted" : {"_value" : "Baroness Manzoor"}
, "attachment" : {"_about" : "http://data.parliament.uk/resources/1041211/answer/attachment/1", "fileName" : {"_value" : "RMOC-Liothyronine-Guidance-v2.0-final-1.pdf"}
, "title" : "RMOC liothyronine guidance"}
, "dateOfAnswer" : {"_value" : "2019-01-22", "_datatype" : "dateTime"}
, "groupedQuestionUIN" : [{"_value" : "HL12791"}
, {"_value" : "HL12792"}
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, "questionFirstAnswered" : [{"_value" : "2019-01-22T16:17:24.437Z", "_datatype" : "dateTime"}
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, "answeringDeptId" : {"_value" : "17"}
, "answeringDeptShortName" : {"_value" : "Health and Social Care"}
, "answeringDeptSortName" : {"_value" : "Health and Social Care"}
, "date" : {"_value" : "2019-01-14", "_datatype" : "dateTime"}
, "hansardHeading" : {"_value" : "Liothyronine"}
, "houseId" : {"_value" : "2"}
, "legislature" : [{"_about" : "http://data.parliament.uk/terms/25277", "prefLabel" : {"_value" : "House of Lords"}
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], "questionText" : "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.", "registeredInterest" : {"_value" : "false", "_datatype" : "boolean"}
, "tablingMember" : {"_about" : "http://data.parliament.uk/members/2024", "label" : {"_value" : "Biography information for Lord Hunt of Kings Heath"}
}
, "tablingMemberPrinted" : [{"_value" : "Lord Hunt of Kings Heath"}
], "uin" : "HL12793"}
, {"_about" : "http://data.parliament.uk/resources/1041212", "AnsweringBody" : [{"_value" : "Department of Health and Social Care"}
], "answer" : {"_about" : "http://data.parliament.uk/resources/1041212/answer", "answerText" : {"_value" : " 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> 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> 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> 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> 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 Guidance \u2013 Prescribing of Liothyronine<\/em> is attached.<\/p>"}
, "answeringMember" : {"_about" : "http://data.parliament.uk/members/4289", "label" : {"_value" : "Biography information for Baroness Manzoor"}
}
, "answeringMemberPrinted" : {"_value" : "Baroness Manzoor"}
, "attachment" : {"_about" : "http://data.parliament.uk/resources/1041212/answer/attachment/1", "fileName" : {"_value" : "RMOC-Liothyronine-Guidance-v2.0-final-1.pdf"}
, "title" : "RMOC liothyronine guidance"}
, "dateOfAnswer" : {"_value" : "2019-01-22", "_datatype" : "dateTime"}
, "groupedQuestionUIN" : [{"_value" : "HL12791"}
, {"_value" : "HL12792"}
, {"_value" : "HL12793"}
], "isMinisterialCorrection" : {"_value" : "false", "_datatype" : "boolean"}
, "questionFirstAnswered" : [{"_value" : "2019-01-22T16:17:24.483Z", "_datatype" : "dateTime"}
]}
, "answeringDeptId" : {"_value" : "17"}
, "answeringDeptShortName" : {"_value" : "Health and Social Care"}
, "answeringDeptSortName" : {"_value" : "Health and Social Care"}
, "date" : {"_value" : "2019-01-14", "_datatype" : "dateTime"}
, "hansardHeading" : {"_value" : "Liothyronine"}
, "houseId" : {"_value" : "2"}
, "legislature" : [{"_about" : "http://data.parliament.uk/terms/25277", "prefLabel" : {"_value" : "House of Lords"}
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], "questionText" : "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.", "registeredInterest" : {"_value" : "false", "_datatype" : "boolean"}
, "tablingMember" : {"_about" : "http://data.parliament.uk/members/2024", "label" : {"_value" : "Biography information for Lord Hunt of Kings Heath"}
}
, "tablingMemberPrinted" : [{"_value" : "Lord Hunt of Kings Heath"}
], "uin" : "HL12794"}
, {"_about" : "http://data.parliament.uk/resources/1037606", "AnsweringBody" : [{"_value" : "Department of Health and Social Care"}
], "answer" : {"_about" : "http://data.parliament.uk/resources/1037606/answer", "answerText" : {"_value" : " The Department engaged with 79 organisations as part of the process of reviewing of the National Health Service (Charges to Overseas Visitors) (Amendment) Regulations 2017 and received 57 formal responses. Of these, 22 case studies included instances where individuals were required to make advance payment for treatment that the Department has concluded was arguably, on proper analysis, immediately necessary and/or urgent.<\/p> The common issue in these cases is that clinicians have not fully taken into account the date at which those seeking treatment have been expected to leave the United Kingdom, something that national guidance is clear must be taken into consideration when making a decision as to whether or not treatment is considered urgent. To mitigate this risk and help ensure the regulations are applied as intended the Department has updated its guidance, published on 24 December 2018, and is planning further updates to relevant training material and case studies in early 2019 to ensure all relevant circumstances are considered when deciding if a treatment is to be considered immediately necessary, urgent or non-urgent.<\/p>"}
, "answeringMember" : {"_about" : "http://data.parliament.uk/members/4289", "label" : {"_value" : "Biography information for Baroness Manzoor"}
}
, "answeringMemberPrinted" : {"_value" : "Baroness Manzoor"}
, "dateOfAnswer" : {"_value" : "2019-01-22", "_datatype" : "dateTime"}
, "isMinisterialCorrection" : {"_value" : "false", "_datatype" : "boolean"}
, "questionFirstAnswered" : [{"_value" : "2019-01-22T16:03:35.98Z", "_datatype" : "dateTime"}
]}
, "answeringDeptId" : {"_value" : "17"}
, "answeringDeptShortName" : {"_value" : "Health and Social Care"}
, "answeringDeptSortName" : {"_value" : "Health and Social Care"}
, "date" : {"_value" : "2019-01-08", "_datatype" : "dateTime"}
, "hansardHeading" : {"_value" : "Health Services: Foreign Nationals"}
, "houseId" : {"_value" : "2"}
, "legislature" : [{"_about" : "http://data.parliament.uk/terms/25277", "prefLabel" : {"_value" : "House of Lords"}
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], "questionText" : "To ask Her Majesty's Government how many written submissions they have received as part of the review of the National Health Service (Charges to Overseas Visitors) (Amendment) Regulations 2017; how many case studies were submitted to the review where urgent care was withheld; and what assessment they have made of the number of case studies submitted where urgent care was, or may have, been incorrectly withheld.", "registeredInterest" : {"_value" : "false", "_datatype" : "boolean"}
, "tablingMember" : {"_about" : "http://data.parliament.uk/members/2024", "label" : {"_value" : "Biography information for Lord Hunt of Kings Heath"}
}
, "tablingMemberPrinted" : [{"_value" : "Lord Hunt of Kings Heath"}
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}