Liothyronine (LT3) prescribing in England: Are cost constraints inhibiting guideline implementation?
Authors' conclusion
Liothyronine costs fell after the CMA ruling but remain orders of magnitude higher than for levothyroxine. The remaining 0.2% of patients with liothyronine treated hypothyroidism are still absorbing 16% of medication costs. The lower liothyronine 5cmg and 10 mcg doses as recommended by BTA are 240% the costs of the 20 mcg dose. Thus, following latest BTA guidance which recommends the lower liothyronine doses still incurs substantial additional costs vs the prescribing liothyronine in the no longer recommended treatment regime. High drug price continues to impact clinical decisions, potentially limiting liothyronine therapy availability to a considerable number of patients who could benefit from this treatment.
Study context
- Population
- Primary care prescriptions in England for levothyroxine, liothyronine and Natural desiccated thyroid (NDT), 2016–2022
- Outcome
- Liothyronine prescribing and cost by dose
- Follow-up
- 2016–2022
Methodological detailsmonthly primary care prescribing data, rolling 12-month totals/averages
- Monthly primary care prescribing data
- Rolling 12-month totals/averages
Main finding
As reported in the abstract
- Share of liothyronine prescriptions of 20 mcg dose, 2016
- 94%
- Share of each of 5 mcg and 10 mcg doses by 2022
- nearly 27%
- 20 mcg cost/prescription, 2016 to 2022 (fell by 80%)
- £404 to £101
- 10 mcg cost/prescription, 2016 to 2022 (fell by 35%)
- £348 to £255
- 5 mcg cost/prescription, 2016 to 2022 (fell by 38%)
- £355 to £242
- Total liothyronine prescriptions, 2016 vs most recent (15% lower)
- 74,605 vs 60,990
- Total liothyronine costs fell by 70% to
- £9 m/year
Observational data: associations, not effects.
Original publication
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