Hi, my partners dog was diagnosed with Addison's disease roughly 18mths ago. He is very well, you would never know there was anything wrong with him, as long as he has his daily Florinef tablets. However, when collecting his prescription today, my partner was told that the tablets had gone up from £22 for 100 tablets to £160 for the same amount!

The receptionist was not able to give a reason for this extortionate increase in cost. Has anyone else whose dog has this condition encountered this? Our dog currently needs 200 tablets a month.

Have a look on line but you will need a vet prescription the price seems to vary from £58 to £115 per 100 I would also rung s couple of other vets to see if they can help

My dog has Atypical addisons so only needs prednisolone (cortisol replacement).  However I did ask my vet some time ago why everyone in USA, Canada etc seems to prefer using Percorten, which a UK vet can get but has to apply for a licence to bring it over.  She informed me a couple of weeks ago a new drug Zycortal is being introduced into the UK which is the same as Percorten and has to be injected.  I know a few people with Addisons dogs here in the UK have been told that Florinef is being discontinued for dogs.

The reason for the cost of Florinef going up is due to it's licence running out and the company not renewing it due to them developing a new injectable drug. So soon you will not be able to buy Florinef at all - a generic version is available but they have also increased the cost of this (by 200-700% in some cases). Florinef (and it's generic counterparts) is a 'human' drug and the new injectable drug (the UK version of Percoten) is licenced as an animal drug - this means that vets will have to use this drug over generic Florinef anyway. There will be some loopholes to this, say if the dog does not react well to the new drug, but basically everyone's hands have been forced. By all accounts most dogs do as well if not better on the injectable drug but it is not nice how this has been forced upon us with little to no warning to owners or vets. I am personally very anxious about the transition from pills to injections for my dog with Addison's, I'm not happy at all.

Also the new drug will likely cost more than Florinef but less than the 'new' Florinef price :/

Hello, I've joined this Forum specifically for this discussion. I've got myself into a right state about the cost of Florineff, my 7 year old Doberman has 6 tablets a day, and only needs prednisolone when she's going to be exposed to stressors, kennels (very rarely) or if my husband has to go away. Florineff for us was her life saver, she nearly died following a nasty poisoning at some kennels and them not giving her, her tablets for two weeks. I range Aspen Pharmaceutical today to ask about the price jump and the lady I spoke to could not help at all, she had a stock answer which she read out. My pharmacist is seething as he's had three people (myself included) begging for his entire stash. He even had one lady break down in tears!

Is there an alternative I don't want to go over to Zycortal as my dog has finally just settled onto her treatment and he last 6 kidney enzyme tests have been spot on! Also I've heard that with Zycortal she'll have to have daily supplementation with pred too, which totally spaces her out (As well as making her urinate all the time - causing her upset as she try's to hide it if she's been caught short in the house.).

I'm desperate :( ...... I dread to think of the cost of this massive price jump to the NHS

Sam

Hello, We have just been given the same devastating news. Our monthly cost has increased from £60 to £480 a month. We are searching the internet to try and locate supply. Has anyone else found a reliable source?
We have been told that there is an alternative injection, does anyone else know the price of it?

Doesn't your pet insurance cover this treatment?

No we only had limited cover and that was used 2 years ago when he was first diagnosed. we have cover for new conditions but not the Addisons.

We have the top whack pet insurance and ours doesn't cover it anymore either.

I emailed the company that manufacture Florinef, for some information and I was appalled that there response was "it's only available in Australia now" I am disgusted by this. Go round as many pharmacies as you can to get what you can that's left. I've managed to pick up my full quota of prescription for Ebony and have 4 months worth, so hopefully we have more time to think of/find a new treatment plan.

If anybody is using the injection any feedback would be brilliant.

Thanks,

Did you go to pet pharmacies? We have 6 days supply left and are still waiting for our vet to get back to us regarding future treatment. we would also appreciate feedback on the injection - cost and how pets have adjusted.  Thanks for reply.

No we have always just got them from Tesco pharmacy, but they are used to getting them in for us. We took her prescription a couple of weeks ago and they gave us 126 tablets I popped in yesterday to pick up the piece of paper to try and take it elsewhere (as we leave the prescription form there) and the pharmacist said they had contacted several suppliers to get them for us.

Do you go to a regular vet or a referral centre? our referral centre is fantastic and they often offer treatments that regular vets aren't able to get just yet. Good luck with future treatment, please let me know what treatment path you choose and how you get on.

Thanks, we have always had them from our local vet.  How much did they charge you for 126 tablets? I am still waiting for Vet to call but will keep you informed.

I have just spoken to my vet and she has explained that the cost of the injection -including consultation to administer will be roughly £56.00 every 25 days plus an extra tablet every day (a steroid) that will cost about £5.00 a month. This is about the same as we are paying now for Florinef treatment. So, hopefully not as bad as we thought. They need to reduce the Florinef over a few days so you need to arrange with your vet to manage the transition while you still have a supply of Florinef.
I am also waiting to see if a local pharmacist can get me Florinef. They have ordered 100 for tomorrow at £21.00 but I'm not convinced the price is right so will let you know.

In terms of cost that's great, I assume the steroid your dog will be taking will be prednisolone (it is an amazing medication) however you need to start giving your dog joint supplements, prednisolone degenerates joints it should not be used long term (I have taken it on and off for various allergies and have been assured by my consultant my joints will never be the same again, not good at the age of 28!). It also makes them drink and urinate loads and loads, and in my dog it changes her personality it makes her really really chilled and cuddly which is quite sweet but it's not her! What injection is your dog going to have is it zycortal?

I paid £9 for 174 tablets which is what their normal price was until it was hiked up

Hi, I too have just joined this forum to discuss the problem with obtaining Florinef. Our vet informed us it has gone up to 10x the price and they will be moving to Zycortal injection.  I have been told they have ordered the Zycortal and they think my dog will need 1.5 vials each time it is administered. I understand this is around £60 per vial. The steroid that has to be taken is Prednisolone and will be £1.30 per tablet and my dog has to have 2 per day. This equates to roughly £90 per injection and £78 per month for the steroid tablets. That is a massive increase in cost as I used to just pay £19 per month for Florinef up to now.

I have tried everywhere for Florinef as my dog is stable on it but I have been quoted huge prices everywhere.  I have only found one online pharmacy which has Florinef at the old price but they refused to sell it to me as I have a veterinary prescription and they say it is for human prescription use only.

I see some people here have obtained Florinef from pharmacies but I cannot find one who will supply it - only veterinary suppliers will fulfil the vets prescription.

Can anyone offer any clarification on this please?

Thanks

> I have tried everywhere for Florinef as my dog is stable on it but I have been quoted huge prices everywhere.  I have only found one online pharmacy which has Florinef at the old price but they refused to sell it to me as I have a veterinary prescription and they say it is for human prescription use only.<br /><br />I see some people here have obtained Florinef from pharmacies but I cannot find one who will supply it - only veterinary suppliers will fulfil the vets prescription.<br />

Have Been asked to post this for you
"Florinef has totally gone out of production, even for humans, and that the cheapest alternative is the Zycortal injection, after the repeated blood tests have determined that the dog is stable on the dose. Also the prednisolone tablets are as cheap as chips; about £3.50 for 60 tablets"

a site selling the tablets at £0.69 per 25mg tablet less for the lower ones
https://www.viovet.co.uk/Prednidale_Tablets_Prednisolone_for_Dogs_Cats/c3732/
£0.66
http://www.vetdispense.co.uk/68-prednisolone

Thanks for your reply. The price I quoted for the Prednisolone was from the vets. Like you I have now found them at 69p each on a website which is obviously cheaper, but even online it will cost me £42 per month for Prednisolone (2 daily at 69p each) and £90 for Zycortal, which is a huge increase on my current £19 month for Florinef. It is a real worry.

Chemistdirect accept vet prescriptions, they have preds. Worth looking at the human online ones if local pharmacies wont sell.

Thanks for your reply. I know about Chemist Direct as that is where I have found the Prednisolone at 69p each which I mentioned in my previous post.  It is the Florinef I cannot get hold of.

Thanks for your reply. I know about Chemist Direct as that is where I have found the Prednisolone at 69p each which I mentioned in my previous post.  It is the Florinef I cannot get hold of.

Unless any local pharmacies still have some in stock you wont get it as its being discontinued full stop. I would look at human pharmacies for the Preds. Not sure if you can get the injections online too that you mention as that's an alternative

You may have been quoted for a different variety of pred, there are several and one is very expensive.  Saffi was on it when she first developed IMHA and it cost me an absolute bomb, now she's fine on the cheap pred and it costs me £7.96 a month for 45 x 5mg tablets (with dispensing fee, so less than that for the actual tablets).

Hi, unfortunately my dog has to take 50mg per day of Pred (2 x25mg) so the 45 x 5mg you mention for £7.96 would be around 4 days supply for her. It really adds up fast

Article about this in Our Dogs paper this week - I can't see it on line yet

Yep, it's the more expensive ones you've been quoted for then.  That's what Saffi was on previously when her disease first began.

I am confused why you think I am on the expensive Preds. The ones I buy cost me £1.38 per day (my dog needs 50mg per day so that is 2 X 25mg tablets at 69p each). You seem to think the ones you use now would be cheaper for me but they are 5mg tablets and my dog would need to take 10 of those each day (50mg per day so that is 10 X 5mg ). You said that 45 tablets cost you £7.96 so that is 17.5p each. Giving my dog 10 of those would be £1.75 per day so that is even more than I am paying now. Is that correct?

On the second site I linked to the 5mg one's are £0.07 each so ten would be £0.70 per day verses the £1.32 for two of the 25mg ones

On the first site the 5mg are 5p each so that would be 50p per day, they also appear to be offering free delivery on orders over a certain amount so if you spent that much no extra cost for that.

I don't think the ones I use would be cheaper for you, now I see how much you need to give per day.  I gave my cost in case you'd been quoted a silly price by the vet, so you had an idea for comparison, as others have done.

Pet Drugs Online have the 5mg tabs at 0.4p each, but are much dearer for the 25mg ones.

Thanks, my prescription is for 25mg tablets so would need to pay for a new prescription for 5mg tablets if I order those.

My dog had her first Zycortal injection today which cost £12.60 for the consultation, £144.28 for the Zycortal injection the Prednidale I discussed above (2x25mg required daily) on top of that. She has to go back in 10 days for another consultation (£12.60) and electrolytes (£29.40) and then again in 25 days for electrolytes and consultation again (approx another £40) at which point another injection of Zycortal will be needed and we start the process all over again.

This will prove to be very expensive.

That is an outrageous cost. It is so unjust that the Florinef tablets are still available in one part of the world, but not to others. Heartbreaking.

I read that worldwide they are stopping production, if not then why cant they be shipped in from originating country through a prescription?

Florineff has to be kept chilled so it can't be shipped. Florineff is still available in the UK under a different name however it's £1 a tablet. I rang Aspen pharmaceuticals who manufacturer it, it appears this cost increase is to ust screw the NHS our of more money with no thought to the veterinary channel.

I see we are all having to use pred for our dogs, is no one else concerned about the side effects of this? it degenerates the joints, and puts additional strain on the kidneys.

Hows everyone getting on with Zycotal?

Florinef is a trademark. The Uk marketing authorisation holder has been undertaken by various companies such as E.R Squibb & Sons and currently Aspen Pharma Trading. It's manufacturered and packaged buy various companies under licence namely Lawerence Laboratories in Ireland and Haupt Pharma in Germany. The active drug is Fludrocortisone Acetate. Our Dog has been taking Fludrocortisone Acetate for the majority of his treatment but we have used Florinef and Fludrocortisone or a combination to make up his dose with no issues what so ever.

Due to the price increase of Fludrocortisone Acetate and Florinef we asked if we could switch to Zycortal but our vet didn't want to change because our dog is doing so well on Fludrocortisone. We've just purchased 3 months supply at £1,380, 12 bottles. (usual price £84) The Pet Insurance claim form  was sent the next day. We are hoping it won't be a issue because our Vet wouldn't change, we have in writting!

I have purchased Florinef from Well chemist with a prescription from my vet. We have paid £72.00 for 1000. They aren't sure how much longer they can get them at this price. It is actually a third the price I was paying from the vet before the price increase. Thanks for your help and advise.

I have just joined the forum and hope I can help with people's concern about the change over from florinef to Zycortal. I had a dog with Addison's disease myself who lived 12 years post diagnosis. I have been a member of support groups for dogs with Addison's for over 18 years now and have written an article to help owners making the transition. I don't know if I am allowed to post links to a facebook group specifically for Addison's, or even give an email address where you can contact me so that I can email you the infomation, but would like to be able to those who are worried about it, if someone could advise me how I may best do that please.

Pam

I think fb group links are fine as is suggesting people pm you for more info

Ok thankyou.
I belong to several fb groups for dogs with Addison's. This is one of them where I am an admin - this one has a bigger UK base than the others.

https://www.facebook.com/groups/addisonsdiseaseindogs/

This is a link to the article I wrote about changing from florinef to Zycortal and it includes info about the new drug and a summary of how people have found the change so far.
http://tinyurl.com/hghp5ns

I hope it helps those of you worried about the changeover.

Get in touch if you want more info

Pam

Just a bit more info, if you go to the link below you can download the Zycortal packet insert which provides information about using the drug and adjusting the dose etc. it also has a case study listing adverse effects on a sample of 113 dogs.

http://www.dechra-us.com/products/pharmaceuticals?s=ZYCORTAL

it is worrying as mentioned earlier our dog has been  on Fludrocortison Acetate for the majority of his treatment  and he's  doing so well. hence we are reluctant to change and upset the apple cart.
I would love to hear from any loving dog owner who decided to make the change and their
dog is doing better on Zycortal and Pred.

Many people on the Addison's disease facebook group have successfully changed their dogs over to Zycortal. The drug is virtually the same as the injectable drug Percorten which has been used across the world for many years now. The key to making the change is in making sure the vet adjusts the dose of Zycortal according to the lytes results and also prescribes a small daily dose or pred.

I'm not worried about the transition itself, the procedure is basically the same (starting dose, monitor and adjust). The information Dechra published on the packet insert has everything you or your vet need to know. The question is which treatment is better for the Dog? People have mentioned joint problems and behaviour changes Pred for example.

For the time being we are going stay with Fludrocortisone Acetate because our dog is doing so well, no noticable side affects and his electrolytes are stable. The other reason is convenience he has  blood tests are every six months and we get a six months repeat prescription.  No going to the vet every  25 days and you've still got to administer daily pills, what's the advantage? I must point out we are covered by insurance up to 7,500 per year.

My dog has had Addison's for roughly three years and is on 10 - yes ten tablets a day for Florinef.  He can't travel in a car for the injections of Zycortal as it upsets him so much.  Can anyone suggest where there might be a supply of Florinef available in County Durham?  I get a prescription for 1500 which roughly lasts him 6 months, and I'm concerned that I will have no choice but to put him down if the new prices remain!  Please help anybody x

Can the vet come out to administer the injections in your own home? Cant see why they wouldn't. Have you asked in local pharmacies if they have any in stock and whether they would accept a vets prescription?

I would ask to be shown how to administer the injection yourself - it may sound daunting but in actuality not that difficult to do

Many people whose dogs are on the equivalent drug in the US -percorten -buy it online a lot cheaper with a prescription from the vet and then give the injection at home themselves. If a vet is unhappy about giving you the injection, just remind them that diabetic dogs are injected at home. Once the optimum dose of Zycortal is found it can work out a lot cheaper than fludro. We have a couple of people on our groups from up your way. If they live near enough, maybe they would even help out giving the injections ?
At my vets, if a nurse gives an injection instead of a vet, there is no charge for giving it, so something else to discuss with your vet.

If the lowest dose of Zycortal and pred are given, there should be no side effects at all. The drugs simply replace the aldosterone and cortisol the dog would make naturally. Unfortunately, since Zycortal was launched in April, I have seen quite a few incidents of vets giving much too high a dose of pred and also of Zycortal than a dog needs. There is evidence in the US that some dogs as big as 100 lb, need as little as 1 mg pred daily.

If you join our fb support group, you will be able to hear from several owners across the UK whose dogs are doing well and indeed some that are doing better than they were on florinef as they can now give the glucocorticoid ( steroid) element separately and hence give a much smaller dose than they had been getting from within the florinef.

The only unwanted side effects so far are from too high a dose than is needed being given the first time, but providing vets are willing to reduce the dose according to the lytes results, those side effects will disappear.

I have written a Guide for
UK Owners about the transition if anyone wants a copy.

You have the 'Well' pharmacy chain in County Durham so it might be worth trying them. We have got 2000 Florinef for £140.00 to last us for 9 months from our local Well pharmacy. Our vet provided a private prescription and charged £8.50. The pharmacy have said that the price may double shortly but double the price is still a lot cheaper than the vets. We want to keep our 11 year old dog on Florinef as long as possible but are pleased to see that this forum is discussing the alternatives available in case Florinef supplies run out. Hope this helps.