Actavis accused of overcharging NHS for hydrocortisone tablets

Actavis Biologics Ltd, Estuary Banks, Liverpool

The Competition and Markets Authority (CMA) has accused pharmaceutical company Actavis UK of breaking competition law by charging the NHS excessive prices for hydrocortisone tablets.

Actavis UK (formerly Auden Mckenzie) increased the price of 10mg hydrocortisone tablets by over 12,000% compared to the branded version of the drug, which was sold by a different company prior to April 2008. The amount the NHS was charged for 10mg packs of the drug rose from £0.70 in April 2008 to £88.00 per pack by March 2016.

Actavis UK also increased the price of 20mg hydrocortisone tablets by nearly 9,500%, charging the NHS £102.74 per pack by March 2016, up from £1.07 per pack.

Debranded (generic) drugs are not subject to price regulation.

Andrew Groves, the senior responsible officer at the CMA, the UK competition watchdog, said: “This is a lifesaving drug relied on by thousands of patients, which the NHS has no choice but to continue purchasing. We allege that the company has taken advantage of this situation and the removal of the drug from price regulation, leaving the NHS – and ultimately the taxpayer – footing the bill for the substantial price rises.”

Hydrocortisone tablets are used as the primary replacement therapy for patients with adrenal insufficiency, such as Addison’s disease. Around 943,000 packets of hydrocortisone tablets were dispensed in the UK in 2015.

Prior to April 2008, the NHS spent about £522,000 a year on hydrocortisone tablets, but in 2015 it spent £70m.

This month, the CMA fined Pfizer and Flynn Pharma a total of nearly £90m for charging excessive prices for the anti-epilepsy drug phenytoin sodium, after that drug was also debranded. In February 2016, it fined several pharmaceutical companies a total of £45m for anti-competitive agreements and conduct in relation to the supply of the antidepressant drug paroxetine. The CMA has three other ongoing investigations into the pharmaceutical sector.

Meanwhile, US authorities have accused six pharmaceutical firms from the US, India and Australia of price fixing by conspiring to raise the price of the antibiotic doxycycline and diabetes drug glyburide.

A civil lawsuit has been filed in 20 US states. Mylan, Heritage Pharmaceuticals, Teva Pharmaceutical USA and Citron Pharma, Aurobindo Pharma and Australia’s Mayne Pharmaceuticals are named in the lawsuit. Criminal charges have been brought against two former executives at Heritage.

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Citation
The Pharmaceutical Journal, PJ, January 2017, Vol 298, No 7897;298(7897):DOI:10.1211/PJ.2016.20202106