Endocrine Abstracts (2017) 50 P395 | DOI: 10.1530/endoabs.50.P395

Recent liothyronine price increases have changed primary care prescription practice, with increased referrals to specialist care

Isabelle Terry1, Petros Perros2,3 & Carla Moran3,4


1University of Cambridge, Cambridge, UK; 2Newcastle upon Tyne NHS Hospitals Foundation Trust, Newcastle, UK; 3SfE Thyroid Network, London, UK; 4Cambridge University NHS Foundation Trust, Cambridge, UK.


Background: The cost of liothyronine (T3) has significantly increased, possibly affecting prescription practices.

Methods: An online questionnaire was designed to assess current T3 use by UK endocrinologists and to determine whether the price increase resulted in a change in primary care prescription practices. Consultant grade members of the Society for Endocrinology Thyroid Network were invited to partake.

Results: Results were analysed from 50 consultant respondents; the majority (85%) were aware of the recent price increase in T3 and had received queries from GPs reluctant to prescribe T3 in the past month (82%); 73% had received patient queries. While most trusts (63%) had no restrictions in place for T3 prescription, almost half (44%) of CCGs provided guidance regarding restriction of T3 use to GPs.

The majority (82%) found the BTA guidance on T3 use helpful, with most (61%) welcoming further advice.

T3 was prescribed by the majority (73%) of respondents, but very infrequently (84%; <1 patient/month) and mostly due to patient request. Respondents indicated that very few (<5%) patients attending clinic were treated with T3 alone (98%). Only 9% used thyroid extract. Most respondents (57%) are equally likely to use T3 compared with 2 years ago.

Conclusions: T3 is used by the majority of UK consultant endocrinologists to treat hypothyroidism, but very infrequently. Price changes in T3 have raised GP reluctance to prescribe T3, resulting in increased secondary care involvement. Current guidance from the BTA regarding T3 use is well regarded, but further advice given the price changes would be welcomed.

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