Trends in thyroid hormone prescribing and consumption in the UK.
BACKGROUND
Thyroid hormone replacement is one of the most commonly prescribed and cost effective treatments for a chronic disease. There have been recent changes in community prescribing policies in many areas of the UK that have changed patient access to necessary medications. This study aimed to provide a picture of thyroid hormone usage in the UK and to survey patient opinion about current community prescribing policies for levothyroxine.


METHODS
Data on community prescriptions for thyroid hormones in England between 1998 and 2007, provided by the Department of Health, were collated and analysed. A survey of UK members of a patient support organisation (the British Thyroid Foundation) who were taking levothyroxine was carried out.


RESULTS
The amount of prescribed thyroid hormones used in England has more than doubled, from 7 to almost 19 million prescriptions, over the last 10 years. The duration of prescriptions has reduced from 60 to 45 days, on average over the same time. Two thousand five hundred and fifty one responses to the patient survey were received. Thirty eight percent of levothyroxine users reported receiving prescriptions of 28 days' duration. 59% of respondents reported being dissatisfied with 28-day prescribing.


CONCLUSIONS
Amongst users of levothyroxine, there is widespread patient dissatisfaction with 28-day prescription duration. Analysis of the full costs of 28-day dispensing balanced against the potential savings of reduced wastage of thyroid medications, suggests that this is unlikely to be an economically effective public health policy.
Endocrine Unit, Royal Victoria Infirmary and Institute of Human Genetics, Newcastle University, Newcastle upon Tyne, UK. annamitchell@doctors.org.uk
Anna L
AL
Mitchell
Bryan
B
Hickey
Janis L
JL
Hickey
Simon H S
SH
Pearce
D003365:Costs and Cost Analysis; D016527:Drug Costs; D004363:Drug Utilization / Q000191:economics / Q000639:trends*; D019538:Health Care Surveys; D006801:Humans; D010818:Practice Patterns, Physicians' / Q000639:trends*; D055553:Prescription Drugs; D013963:Thyroid Hormones / Q000191:economics / Q000627:therapeutic use; D013974:Thyroxine / Q000191:economics / Q000627:therapeutic use; D006113:United Kingdom
D055553:Prescription Drugs; D013963:Thyroid Hormones; D013974:Thyroxine