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Plans to withdraw GP-prescribed lithium drug halted


Lithium


A drug manufacturer has backtracked on plans to discontinue a widely-used lithium drug for bipolar disorder after an investigation was launched into whether the company had broken the law.

Essential Pharma had originally announced it would be withdrawing Priadel in April 2021 which would force clinicians to switch patients to more expensive brands including the company’s other lithium-based drug Camcolit.

The Competition and Markets Authority said it would be looking into whether the pharmeutical company ‘has abused a dominant position’ by proposing to withdraw the supply of Priadel to UK patients after significantly raising the price of Camcolit at an estimated cost to the NHS of £15m a year.

In an update to prescribers, the Department of Health and Social Care confirmed that Essential Pharma said it would ‘reverse the discontinuation of Priadel 200mg and 400mg tablets from the UK market with immediate effect’.

DHSC officials said while they could not confirm the drug would not be withdrawn in the future the company would have to give six-months notice. The CMA investigation remains open.

Discussions between health officials and the company over pricing are ongoing but the company said stocks of Priadel were sufficient to meet current UK demand and they were working to maintain supply after April.

Prescribing figures from January show more than 65,000 items dispensed for Priadel.

The CMA investigation was launched after medical organisations, including the RCGP and Society of Academic Primary Care, sent a letter to Matt Hancock warning that the removal of Priadel would increase NHS costs, risk patient safety and put pressure on already stretched services.

‘Lithium is an essential medication recommended by NICE guidance; it is proven to treat bipolar disorder and to prevent suicide.

‘If it is stopped suddenly there is a significant risk of rebound relapse. If levels become toxic, it can cause permanent kidney damage and can be fatal,’ the letter warned.

GPs and community pharmacists said they had already received phone calls from patients worried they would have to switch or stop their medicine and urged the health secretary to intervene.

RCGP vice chair Dr Gary Howsam, co-signatory to the letter, said lithium was a vital medication for patients with bipolar disorder.

‘Withdrawing one common brand and increasing the price of another will be to the financial detriment to the NHS, it will increase workload on an already pressurised primary care service, and it will be confusing for patients and risk their safety as the two brands aren’t directly or easily interchangeable.’