• drug-related side effects and adverse reactions
• health care quality
• access
• evaluation

In August, it was announced that Essential Pharma would be discontinuing the supply of Priadel (lithium carbonate) 200 mg and 400 mg modified-release tablets in the UK and that stocks of both strengths were expected to run out by April 2021.¹ The small number of alternative lithium products available in the UK are substantially more expensive than Priadel and the process of changing to a different formulation of lithium carbonate will be a costly and disruptive process for patients and the health service. Has the intervention of the Competition and Markets Authority (CMA) ensured that this formulation of lithium will remain available and removed the threat of disruption?²

Priadel currently costs the National Health Service (NHS) £2.76 for a 100 tablets of 200 mg or £4.02 for the same number of 400 mg tablets.³ Essential Pharma also produces Camcolit (lithium carbonate 400 mg modified release tablets), which costs £48.18 per 100 tablets, up from £4.30 after price increases starting in 2017.^{4 5} Essential Pharma’s other lithium option—generic 250 mg film-coated tablets—costs £87 for 100 tablets, after similar price increases beginning in 2016.^{3 6 7} Teofarma produces Liskonum, the only other modified release formulation, which contains 450 mg of lithium carbonate and costs £11.84 for 60 tablets.³ If Priadel is discontinued, however, a 200 mg modified release formulation will not be available in the UK.