• Withdrawal of Priadel by drug company could risk patient health
• Health bodies urge Secretary of State to agree a fair price
• Added pressure on already over-stretched NHS due to COVID-19
Pharmacists, GPs, Psychiatrists and patients are urging Secretary of State for Health and Social Care Matt Hancock MP to ensure a brand of lithium taken by people with bipolar disorder remains available to treat patients in the UK and avert a huge increase in price. The drug is currently paid for by the NHS.
Lithium is an essential medicine proven to treat bipolar disorder and help prevent suicide. One in a hundred people have bipolar disorder and one in five of these take lithium1.
Essential Pharma own the rights to Priadel, a brand of lithium which is relied on by patients and is a low cost to the NHS. The company has announced it is withdrawing the brand and has increased the price of the other main brand of the drug, Camcolit, which it also owns.
Switching treatment can destabilize patients, risking either the medicine becoming less effective, or building to toxic levels can cause severe side-effects including kidney damage. It therefore requires added reviews, extra tests and close monitoring of patients, increasing pressure on primary care and mental health services already over-stretched by the pandemic.
Priadel currently costs £4.02 for a pack of 400mg tablets. Camcolit, the other brand of lithium owned by Essential Pharma, costs almost 12 times more at £48.18 per pack of 400mg tablets2. In direct drug costs alone, it is estimated that this will cost the NHS approximately £15 million annually. The drug is due to be withdrawn in April 2021.
Dr Ian Maidment, Reader in Clinical Pharmacy at Aston University and spokesperson for the Royal Pharmaceutical Society said: “Withdrawing Priadel could put thousands of patients at unnecessary risk of harm. Being unable to get the same brand and dose will affect the physical and mental health of many. We want the Secretary of State to personally intervene to maintain supplies of Priadel so patients with bipolar disorder can still get this vital medicine.”
Ciara Ni Dhubhlaing, President of the College of Mental Health Pharmacy, said: “Pharmacists are already reporting stock shortages and we are deeply concerned about the withdrawal of this essential treatment for this vulnerable patient group. This will cost the NHS millions more each year at a time when finances and services are already stretched due COVID-19.”
Dr Adrian James, President of the Royal College of Psychiatrists, said: “Many patients have been prescribed the same brand of lithium for many years. The possible discontinuation of one brand is causing unnecessary anxiety, not just for patients and carers but for doctors too, who prescribe and monitor this medication. This is not a case of simply switching to another brand, as any change needs to be carefully monitored for effectiveness and side-effects.”
Carolyn Chew-Graham GP and Professor of General Practice Research at Keele University said: "GPs will need guidance and support from specialist mental health colleagues to change people over from Priadel to Camcolit. The increase in workload generated will put added pressure on general practices across the country, cause difficulties and an increased risk of harm for patients."
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1 Lyall LM, Penades N, Smith DJ. Changes in Prescribing for bipolar disorder between 2009 and 2016: national-level data linkage study in Scotland. British Journal of Psychiatry (2019) 215: 415-421. DOI: 10.1192/bjp.2019.16
2 British Medical Association and Royal Pharmaceutical Society of Great Britain (2020). British National Formulary Number 78.