As part of its investigation, the Competition and Markets Authority (CMA) "provisionally" found last year that the pharmaceutical company charged the NHS more than £34 million for liothyronine tablets in 2016 – "an increase from around £600,000" spent on them in 2006, it announced yesterday (November 21).

The cost of a pack of liothyronine rose from £4.46 – before it was debranded in 2007 – to £258.19 by July 2017, which represents a 6,000% increase, the CMA said.

Although liothyronine tablets are not the primary treatment for hypothyroidism, the watchdog pointed out, for many patients there is “no suitable alternative” and until earlier this year Concordia was the only supplier.

Pharmaceutical companies “abuse their position”

CMA chief executive Andrea Coscelli said pharmaceutical companies that “abuse their position and overcharge for drugs” are “forcing the NHS to pay over the odds for important medical treatments”.

“We allege that Concordia used its market dominance in the supply of liothyronine tablets to do exactly that,” Mr Coscelli said.

He stressed that at this stage in the investigation, the CMA’s findings are provisional and there has been “no definite 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,” Mr Coscelli said.

British Generic Manufacturers Association (BGMA) director general Warwick Smith told C+D that although it cannot comment on specific cases, the BGMA would never support “anti-competitive behaviour by any company, particularly if it impacted negatively on patients or the NHS”.

Concordia responds

Concordia said that it "does not believe competition law has been infringed".

“The pricing of liothyronine has been conducted openly and transparently with the Department of Health in the UK over a period of 10 years,” the manufacturer said in a statement on its website.

“Over that time, significant investment has been made in this medicine to ensure its continued availability for patients in the UK,” it said.

"We will review the CMA's preliminary position, as set out in its statement of objections, and we will be responding to it in detail. We continue to work co-operatively with the CMA as it proceeds with its investigation."

NHS England is currently consulting on whether to scrap liothyronine from NHS prescriptions, which it deems to be costly and with limited evidence of its effectiveness.

Last year, the CMA imposed a £84m fine on Pfizer for charging "excessive" prices for epilepsy drug phenytoin sodium, and also alleged that Actavis – since rebranded as Accord – had broken competition law for over-charging the NHS for hydrocortisone tablets.