In a landmark decision covered in breaking news reports, the UK Court of Appeal has upheld a £99 million fine against Advanz Pharma for excessive pricing of the thyroid medication liothyronine.
A Reuters report says: “In a unanimous judgment, the Court of Appeal has confirmed the Competition and Markets Authority’s (CMA) finding of excessive and unfair pricing in the supply of liothyronine tablets in the UK.”
Reports allege the pharmaceutical company significantly overcharged the National Health Service (NHS) for an essential medication used by thousands of patients with thyroid conditions.
Why A Landmark Decision?
News articles allege that the Advanz Pharma case is a landmark case because it marks the first time a UK appellate court has upheld a competition regulator’s finding of excessive pricing in the pharmaceutical industry. This sets a legal precedent that even off-patent drugs are not immune from scrutiny when pricing becomes abusive.
The ruling confirms that exploiting a dominant market position to overcharge the NHS is unlawful. It reinforces the idea that public healthcare systems cannot be treated as commercial opportunities, especially when essential, niche medications are involved.
By upholding the CMA’s decision, the court has validated the power of UK regulators to enforce fair pricing. This judgment strengthens the CMA’s authority and may encourage more aggressive action against future abuses in the sector.
The court’s recognition of the harm to both the NHS and patients makes this more than a financial case. It underscores the ethical cost of profiteering, particularly when patients were denied access to vital treatment due to inflated prices.
This ruling also sends a clear message to pharmaceutical companies worldwide: exploitative pricing practices will not go unchecked. It may influence international regulatory approaches, especially in countries grappling with rising drug costs and strained public health budgets.
What Is Liothyronine?
Liothyronine is a synthetic form of the thyroid hormone triiodothyronine (T3), prescribed primarily for patients with hypothyroidism who do not respond adequately to the more commonly used levothyroxine.
For this group, often those with severe or complex thyroid dysfunction, liothyronine is not just an optional supplement but a critical part of managing their condition and maintaining quality of life. Despite its clinical importance, it is not widely prescribed, making it a niche medication with limited competition in the UK market.
This niche status, however, is precisely what made liothyronine vulnerable to the kind of price manipulation that sparked this legal battle.
The Case Against The Pharmaceutical Company
Reports state that between 2007 and 2017, Advanz Pharma increased the price of liothyronine tablets in the UK from approximately £4.46 to a staggering £258,19 per pack. This is an increase of over 5 000%. Over the same period, the cost of producing the drug remained broadly the same, and there was no evidence of increased research, development, or manufacturing expenses that could justify the rise.
Reports further say that the CMA launched an investigation and concluded that the company had abused its dominant market position. It is alleged that the company had deliberately exploited a loophole that allowed ‘generic’ drugs (those not protected by patents) to be de-branded, thus removing them from NHS price regulation. By doing so, it was able to impose sharp price hikes without the usual constraints.
In 2021, the CMA imposed a fine of £100 million on the company and associated companies. After a series of legal appeals, the UK Court of Appeal upheld £99 million of the fine in May 2025, confirming the unethical and unlawful nature of the company’s pricing strategy.
Beyond the legal and financial dimensions, the real-world impact of such pricing abuses is felt most acutely by patients. Before the NHS took action to source liothyronine from alternative suppliers, some local Clinical Commissioning Groups (CCGs) restricted access to the drug due to its high cost. This left patients in limbo. Some were forced to go without essential medication or pay out-of-pocket. For individuals with thyroid disorders, this meant enduring fatigue, cognitive issues, and reduced quality of life, often with little explanation other than cost.
The ruling is a vindication for those patients and advocacy groups who campaigned tirelessly for the NHS to intervene and for the pricing to be regulated.
A Global Warning
With drug pricing being a major issue globally, this case may inspire similar scrutiny in other countries where healthcare systems are vulnerable to commercial exploitation.
As global supply chains and pharmaceutical companies become increasingly interconnected, the ripple effects of the UK case could help shape future legislation and corporate behaviour across the world.