Concordia International, the Canadian drug company, has overcharged the NHS by more than £100m in the past decade for a life-changing thyroid drug, according to Britain’s competition watchdog.

The Competition and Markets Authority (CMA) said it had provisionally found that Concordia had “abused its dominant position to overcharge the NHS” by hiking the price of liothyronine, used to treat patients with an underactive thyroid, by nearly 6,000% between 2007 and 2017.

The regulator said the NHS had spent more than £34m on the drug last year, up from about £600,000 in 2006. The amount it paid per pack rose from £4.46 in 2007 to £258.19 by July 2017.

The price of a single pill went up from 16p to £9.22, even though production costs remained broadly stable during that period, the CMA said.

Concordia could be fined up to 10% of its worldwide annual turnover.

Liothyronine tablets are used to treat hypothyroidism, a condition caused by a deficiency of the thyroid hormone that affects at least two in 100 people and can lead to depression, tiredness and weight gain.

For many patients there is no alternative and, until this year, Concordia was the only supplier. This summer, the UK firm Morningside Healthcare and Israel’s Teva were granted licences to supply the drug.

The medicine, a synthetic version of the hormone T3, is taken by patients who do not respond well to the cheaper alternative, levothyroxine. It is sold across Europe for a few cents per pill.

The CMA chief executive, Andrea Coscelli, said: “Pharmaceutical companies which abuse their position and overcharge for drugs are forcing the NHS – and the UK taxpayer – 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.

“At this stage in the investigation, our findings are provisional and there has been no definitive 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.”



Concordia and the private equity firms Cinven and HgCapital, the previous owners of Amdipharm Mercury which was acquired by Concordia in 2015, have been asked to respond to the findings.

Concordia said it would review the findings, but added: “We do not believe that 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.

“Over that time, significant investment has been made in this medicine to ensure its continued availability for patients in the UK, to the specifications required by the Medicines and Healthcare products Regulatory Agency in the UK.”

The British Thyroid Foundation said: “There are many thyroid patients who have told us that this medicine makes a huge difference to their lives and the enormous price rise has caused significant confusion and distress.

“We look forward to the CMA’s final decision and very much hope that it will lead to an improvement in care for patients with hypothyroidism.”

The drug industry body said it “does not in any way support or condone any deliberate ‘price hikes’ by pharmaceutical companies”.

Mike Thompson, chief executive of the Association of the British Pharmaceutical Industry, said: “We fully support the CMA in taking action in cases of proven abuse of market power. We also continue to support the government in taking policy steps to ensure such abuses cannot happen in the future.

“This case is yet to conclude, but we do not – and will not – support any company found to have intentionally exploited the NHS.”

In a consultation paper published in July, NHS England recommended that health trusts should not prescribe the pill for new patients. It said it was clinically effective but there were cheaper alternatives.



Concordia is the subject of a further CMA investigation. The regulator said in March in a provisional finding that the Canadian firm had made illegal deals with its rival Actavis UK to inflate the price of life-saving hydrocortisone tablets in Britain.

Last year, the CMA fined the US pharma giant Pfizer and drug distributor Flynn Pharma nearly £90m – including a record £84m penalty for Pfizer – after they increased the price charged to the NHS for an anti-epilepsy drug by up to 2,600%.

Britain’s biggest drugmaker, GlaxoSmithKline, and two other firms were fined £45m over the antidepressant paroxetine. Both decisions are under appeal. The CMA is carrying out seven other investigations in relation to drug pricing and competition issues.

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