The Government is taking urgent action to improve the supply of hormone replacement products in the light of ongoing shortages, although the situation is easing for some products.
Serious shortage protocols (SSPs) have been introduced for several products, restricting dispensing to 3 months’ supply, or to enable pharmacists to substitute high demand preparations, such as Oestrogel, Ovestin cream, Lenzetto transdermal spray and Sandrena sachets, with appropriate alternatives, such as transdermal patches which are in good supply.
‘Giving women the option to substitute products is a safe, effective way to ensure HRT continues to be available for everyone who needs and women can continue to manage their own menopausal symptoms,’ a Department of Health and Social Care (DH) statement says.
The move will also help to avoid confrontation between women and pharmacists – and prescribers – when a prescribed preparation is out of stock.
Meetings between suppliers and the DH has resulted in some suppliers taking ‘swift action’ to secure additional stock of HRT products experiencing shortages, resulting in good availability of Premique Low Dose, for example.
Recently appointed HRT supply tsar, Madeleine McTernan – director general of the vaccine taskforce – said she would be focusing on measures to ensure stocks are used most efficiently whilst also securing ongoing supplies.
NHS England has asked prescribers, before prescribing, to check the availability of HRT products on the NHSE specialist pharmacy service website at https://www.sps.nhs.uk/articles/prescribing-available-hrt-products/.
Advice on clinical equivalence between products is available from the British Menopause Society, at https://thebms.org.uk/wp-content/uploads/2022/01/HRT-Equivalent-preparations-7th-January-22.pdf
Supply issues have been attributed to a number of factors, from lack of raw ingredients during manufacture, distribution problems, and increased demand – prescriptions for HRT have more than doubled in the past 5 years. Prescribing for Lenzetto alone increased by over 1100% between February 2021 and February 2022.1
1. BMJ 2022;377:o1183