Question to the Department of Health and Social Care:

To ask Her Majesty's Government what steps they will take to prevent any harm to thyroid patients who require liothyronine and who are unable to secure funding for such treatment by Clinical Commissioning Groups because of the cost of this medicine set by the three UK licence holders.

Guidance on the prescribing of liothyronine has been published by the Regional Medicines Optimisation Committee (RMOC). A copy of Guidance – Prescribing of Liothyronine is attached. The aim of the guidance is to make best practice on the prescribing of liothyronine clearer. This guidance provides advice on the prescribing of liothyronine and on the review of National Health Service patients who are being prescribed liothyronine. The guidance supports clinical commissioning groups (CCGs) and Area Prescribing Committees in local decision making and enables a consistent approach for the exceptional circumstances in which patients have an ongoing need for liothyronine.

The guidance states that “As specified by the British Thyroid Association Executive Committee, clinicians have an ethical responsibility to adhere to the highest professional standards of good medical practice rooted in sound evidence. This includes not prescribing potentially harmful therapies without proven advantages over existing treatments’. The RMOC therefore recommends that strict criteria are applied to ensure that liothyronine is only prescribed in the very rare situations where alternative treatments have been found to be inadequate. In such circumstances, an ongoing shared care arrangement may be appropriate if agreed by local commissioners. If a patient is ever initiated on treatment, prescribing responsibility should remain with the hospital consultant for at least 3 months”.

CCG 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.

Any patient who feels they have suffered harm as a result of NHS treatment may raise the matter, in writing, electronically, or orally, with the service provider, or with the commissioner of the service. If local resolution is unsuccessful, the person making the complaint has the right to refer their complaint to the Health Service Ombudsman.