Liothyronine tablets: suspected excessive and unfair pricing
Source: gov.uk (2025-05-08)

The CMA investigated alleged excessive and unfair pricing with respect to liothyronine tablets under Chapter II CA98.

Case timetable

Change log

The following changes have been made since the case was opened in October 2016:

Court of Appeal judgment

8 May 2025: The Court of Appeal has unanimously refused Advanz Pharma and Cinven permission to appeal against the Competition Appeal Tribunal (CAT) judgment and has overturned the CAT’s penalty reduction for Cinven following a cross-appeal by the CMA.
- Press release: Court upholds CMA’s £99m fine on pharma over excessive NHS thyroid drug prices (https://www.gov.uk/government/news/court-upholds-cmas-99m-fine-on-pharma-over-excessive-nhs-thyroid-drug-prices) (8.5.25)
- Final judgment (https://caselaw.nationalarchives.gov.uk/ewca/civ/2025/578) (8.5.25)
Competition Appeal Tribunal judgment

8 August 2023: The CAT has upheld the CMA’s findings on liability in all respects, amending the fine to £84.2 million.
- Press notice: CMA defeats legal challenge in medicine pricing case (https://www.gov.uk/government/news/cma-defeats-legal-challenge-in-medicine-pricing-case) (8.8.23)
- Competition Appeal Tribunal judgment (https://www.catribunal.org.uk/cases/141911221-hg-capital-llp) (8.8.23)
Non-confidential infringement decision

15 December 2021: The CMA has published a non-confidential version of the decision in which the CMA fined Advanz Pharma, Cinven and HgCapital over £100 million for their involvement in the charging of excessive and unfair prices in the supply of liothyronine tablets in the UK.
- Non-confidential decision (https://assets.publishing.service.gov.uk/media/61b8755de90e07043f2b98ff/Case_50395_-_Decision_final___.pdf) (15.12.21)
- Annex 1 (https://assets.publishing.service.gov.uk/media/61b875728fa8f5038358c229/Case_50395_-_Non-confidential_Annex_1.pdf) (15.12.21)
- Annex 2 (redacted in full)
- Annex 3 (https://assets.publishing.service.gov.uk/media/61b8757ee90e070446653df2/Case_50395_-_Non-confidential_Annex_3.pdf) (15.12.21)
- Annex 4 (https://assets.publishing.service.gov.uk/media/61b8758b8fa8f5037b09c7e1/Case_50395_-_Non-confidential_Annex_4.pdf) (15.12.21)
- Annex 5 (https://assets.publishing.service.gov.uk/media/61b875c3e90e07044462d863/Case_50395_-_Non-confidential_Annex_5.pdf) (15.12.21)
- Annex 6 (https://assets.publishing.service.gov.uk/media/61b875e08fa8f5037cc5e202/Case_50395_-_Non-confidential_Annex_6.pdf) (15.12.21)
- Annex 7 (https://assets.publishing.service.gov.uk/media/61b875ead3bf7f054f43e2a3/Case_50395_-_Non-confidential_Annex_7.pdf) (15.12.21)
- Annex 8 (redacted in full)
Infringement decision

29 July 2021: The CMA has found competition law breaches in relation to the supply of 20mcg Liothyronine tablets in the UK.
- Press notice: CMA fines pharma firm over pricing of crucial thyroid drug (https://www.gov.uk/government/news/cma-fines-pharma-firm-over-pricing-of-crucial-thyroid-drug) (29.7.21)
Supplementary statement of objections

On 10 July, the CMA issued a supplementary statement of objections. The statement addresses issues arising from the Court of Appeal’s judgment of 10 March 2020 in the phenytoin litigation – a case which relates to excessive and unfair pricing in the pharmaceuticals sector.

The CMA continues provisionally to find that Advanz Pharma breached UK and EU competition law from at least 1 January 2009 to at least 31 July 2017 by charging excessive and unfair prices for Liothyronine tablets in the UK.

High court ruling on Advanz Pharma’s judicial review application

On 5 March 2019, Advanz Pharma applied to the High Court for a judicial review of the CMA’s decision not to suspend the next procedural step in its investigation into excessive and unfair pricing for liothyronine tablets. On 13 June, the High Court dismissed Advanz’s application, enabling the CMA to continue with its investigation.

Supplementary statement of objections

On 30 January 2019, the CMA issued a supplementary statement of objections revising certain aspects of its provisional findings in the statement of objections.

Through this supplementary update, the CMA has slightly altered its investigation period, provisionally finding that Advanz Pharma (formerly Concordia) breached UK and EU competition law from at least 1 January 2009 to at least 31 July 2017 by charging excessive and unfair prices for Liothyronine tablets in the UK.

Between January 2009 and July 2017, the price paid by the NHS for liothyronine tablets rose from £15.15 to £258.19, a rise of 1,605%, while production costs remained broadly stable. During that period, Advanz was the only supplier of liothyronine tablets in the UK.

Statement of objections

On 21 November 2017 the CMA issued a statement of objections alleging that Concordia has breached UK and EU competition law by charging excessive and unfair prices in relation to the supply of liothyronine tablets in the UK.
- Press release: Drug company accused of abusing its position to overcharge the NHS (https://www.gov.uk/government/news/drug-company-accused-of-abusing-its-position-to-overcharge-the-nhs) (21.11.17)
Notes
- The investigation is under Chapter II of the Competition Act 1998 (CA98).
- No conclusion should be drawn that there has been an infringement of competition law at this stage and the recipients of the supplementary statement of objections will now have a further opportunity to respond to the allegations.
- The CMA will consider any representations it receives before any decision is taken as to whether competition law has in fact been infringed.
- Further detail of the CMA’s procedures in Competition Act 1998 cases is available here: CMA’s procedures in Competition Act 1998 cases (https://www.gov.uk/government/publications/guidance-on-the-cmas-investigation-procedures-in-competition-act-1998-cases).
- Changes to the timing of original entries in the case timetable will be made where the estimated timing changes.
Contacts
- Assistant Director: Paul Dean xx-xxxx-xxxx, xxx@xxx.xx (mailto:xxx@xxx.xx))
- Director: Ronan Flanagan xx-xxxx-xxxx, xxx@xxx.xx (mailto:xxx@xxx.xx))
- Senior Responsible Officer: Geoff Steadman xx-xxxx-xxxx, xxx@xxx.xx (mailto:xxx@xxx.xx))