Canadian pharma company Concordia has been accused of hiking the price of its hypothyroidism drug liothyronine by almost 6,000% over 10 years by the UK competition authorities.
Liothyronine cost only £4.46 per pack in 2007, but over the intervening years has spiked to £358.19 per pack in July of this year, according to the Competition and Markets Authority (CMA), which says Concordia “abused its dominant position to overcharge the NHS”.
While most people with reduced thyroid function take low-cost generic levothyroxine tablets, liothyronine is sometimes used in place of or in addition to levothyroxine if patients say they don’t get an improvement in symptoms – such as depression, tiredness and weight gain – using levothyroxine alone.
Some UK clinical commissioning groups argue against prescribing of liothyronine altogether, on the grounds that it has a much shorter half-life than and steady-state levels cannot be maintained with once daily dosing.
“Although liothyronine tablets are not the primary treatment for hypothyroidism, for many patients there is no suitable alternative and, until earlier this year, Concordia was the only supplier,” says the CMA.
The NHS bill for liothyronine use was £600,000 in 2006, it says, but swelled to £34m in 2016 over a period when production costs for the drug “remained broadly stable”. If it is found to have abused its position, under UK law Concordia could be fined up to 10% of its worldwide annual turnover.
Earlier cases brought by the CMA have resulted in hefty fines. Last December, Pfizer and Flynn Pharma were ordered to pay £84m after being accused of charging excessive and unfair prices for anti-epilepsy treatment phenytoin sodium capsules, but have appealed the ruling.
Meanwhile, earlier in 2016 the CMA fined number of pharmaceutical companies in relation to ‘pay-for-delay’ deals that affected the supply of generic paroxetine, an antidepressant developed by GlaxoSmithKline.
“Pharmaceutical companies which abuse their position and overcharge for drugs are forcing the NHS – and the UK taxpayer – to pay over the odds for important medical treatments,” said CMA chief executive Andrea Coscelli.
“At this stage in the investigation, our findings are provisional and there has been no definitive decision that there has been a breach of competition law. We will carefully consider any representations from the companies before deciding whether the law has in fact been broken.”
Concordia said it is “working to better understand the CMA’s position and will continue to work constructively to resolve these matters”.