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Price of anti-epilepsy drug rockets

Clinical commissioning groups have warned that a 24-fold rise in the cost of an anti-epilepsy drug could add £43m to commissioning costs across England.

Phenytoin has increased in price since September from 66p to £15.74 for 28 25mg tablets, and from £2.83 to £67.50 for 84 100mg tablets. This followed the acquisition of the rights by Flynn Pharma from Pfizer.

Sue Smith, head of prescribing and medicines management at Nene and Corby CCG and a pharmacist by training, said the 24-fold increase was ‘difficult to comprehend’.

‘In Northamptonshire, we are spending just over £5k per quarter on Epanutin at current prices, which will potentially increase to £120k per quarter,’ she wrote in a letter to local MPs.
This equated to an estimated £460k per year in additional costs for Northamptonshire CCG and £43 million per year for the NHS as a whole, she added. 

The DH told Corby CCG in a letter that it was holding discussions with the company.

Flynn Pharma is a member of the 2009 Pharmaceutical Price Regulation Scheme, but phenytoin is not covered by the scheme, the DH added.

‘Whilst any price increase is unwelcome, systems are in place to ensure, in the main, the NHS obtains the best value from medicines. For example, we were able to move quickly earlier this year to reduce the cost of atorvastatin to the NHS when it came off patent,’ the DH letter added.

David Fakes from Flynn Pharma confirmed that discussions were taking place but refused to be drawn on specifics. 

Dr Johnny Marshall, interim director for partnership development at NHS Clinical Commissioners, said: ‘We have written to [chief pharmaceutical officer] Dr Keith Ridge asking him why a 24-fold price rise has been agreed at no benefit to patients and to see if there are any steps that can be taken to mitigate the effect on CCG budgets.’

A DH spokesperson said: ‘Our main concern is ensuring epilepsy patients continue to get phenytoin.’

Differing costs


25mg    66p/28 tablets
50mg    67p/28 tablets
100mg    £2.83/84 tablets
300mg    £2.83/28 tablets

25mg    £15.74/28 tablets
50mg    £15.98/28 tablets
100mg    £67.50/84 tablets
300mg    £67.50/28 tablets

Source: BNF, NHS Prescription Services

Readers' comments (4)

  • Vinci Ho

    So a government will keep cutting resources of NHS front line BUT fails to stop greedy pharmaceutical company to rediculously increase twenty odd times the price of an old still useful drug . A loop hole was exploited and this incompetent government cannot do anything. What happen if this is going to repeat with other well used drugs???

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  • This has led to a situation where as a team we have to consider changing patients to other medications with no clinical indication and at a possible risk to their seizure freedom. The neurology time and ongoing support to patients, who are also likely to be elderly, during what can be a difficult transition will be enormous, and detract from the care of other patients. We already have the situation where unlicensed buccal midazolam for epilepsy patients is sold at highly inflated costs as it is a "special". When is the government going to regulate these activities which cost the NHS so dearly? While at the same time cutting pay and pensions?

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  • Buccal midazolam is now licensed, called Buccolam.

    We all need to realise that but the profit level for pharmacy is fixed, just in the last quarter approx £90m has been taken from CatM alone,

    The politics of the pricing regime is crazy and the previous level of 68p is far too cheap, however was most likely part of a negotiation by Pfizer on a huge basket of goods that they have.

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  • Buccolam is only licensed for the 3 months to 18 years age group Niall - there is still no
    licensed buccal Midazolam product for adults.

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