In a letter to the Competition and Markets Authority (CMA) last week (December 11), the Royal Pharmaceutical Society (RPS) and charity the College of Mental Health Pharmacy (CMHP) expressed "concern" about the agreement reached between the Department of Health and Social Care and Priadel manufacturer Essential Pharma last month (November 24).

While the letter “commends” the agreement for Essential Pharma to supply the bipolar drug Priadel (lithium carbonate) 200mg and 400mg prolonged-release tablets for £7.50 and £8.50 per pack respectively for the next five years, questions remain as to what will happen at the end of that period, the RPS and the CMHP said.

Five years is “a short time in the lifetime of a pharmaceutical company”, the two organisations said. “Can we assume there may be a price increase again after five years?"

The letter highlighted the “anxiety and distress” the initial withdrawal announcement had caused many patients and said “many clinicians had to dedicate considerable time to addressing this issue through campaigning and contingency planning to the detriment of their other crucial work”.

To prevent a reoccurrence and to “reduce the ability of companies to hold a dominant position over a particular share of the market and to exploit this position of dominance”, legislation is required, the RPS and CHMP argued.

At the moment “we do not believe that there is anything concrete in place to prevent the need to refer to the CMA in future”, they added.

RPS: "Essential that we now get clarity”

RPS president Sandra Gidley said: “It is essential that we now get clarity on the drug’s long-term future, particularly regarding what will happen once this new price contract ends after the five-year agreement.”

A CMA spokesperson told C+D yesterday (December 16): “In all cases, protection for consumers would not come to an end once commitments expire, as firms must still ensure they comply with the law after this period. So, if a company engaged in practices which the CMA reasonably suspected could break the law after commitments made to the CMA came to end, then the CMA could take further action.”

In August, it was announced that Priadel, used in the treatment of bipolar disorder, was set to be discontinued in the UK by Essential Pharma from April 2021. Essential Pharma told C+D at the time (August 19) that this was “due to restrictions on permitted pricing” that meant the manufacture and supply of the tablets was “no longer viable”.

In September, 12 healthcare bodies, including the RPS, asked health secretary Matt Hancock to “personally intervene” to ensure the drug continued to be available in the UK with an “appropriate pricing structure”.

Last month (November 24) news came that an agreement had been reached between the DH and Essential Pharma to sell Priadel at a price of £7.50 for the 200mg pack and £8.50 for the 400mg pack. 

This is considerably lower than other forms of lithium such as Camcolit 400mg tablets, also owned by Essential Pharma, which is priced at £48.18 per pack.

This followed Essential Pharma's decision to pause the withdrawal of Priadel from the UK market in October, as the CMA opened an investigation into the manufacturer for “suspected anti-competitive practices in the supply of drugs used to treat bipolar disorder”.

Essential Pharma declined to comment on this story when approached by C+D, as the CMA has yet to publish the results of its investigation.