Shortages of HRT products – which are used to relieve symptoms of menopause – have long plagued pharmacy teams, who have battled a surge in demand for the drugs throughout the COVID-19 pandemic.
Even before the pandemic, pharmacy staff reported shortages in all 30 HRT drug brands cited in a C+D survey conducted in March 2020.
Read more: Boots to cover HRT prescription costs for pharmacy team members
But HRT shortages continue to be a concern for pharmacy teams. Earlier this week (5 April), Health Minister Edward Argar confirmed in response to a written parliamentary question that the Department of Health and Social Care (DH) was “aware of the supply issues affecting a very limited number of THS products”.
The DH “will continue to work with all providers” to help “resolve these issues and maintain overall patient supply,” Argar added.
C+D has asked major HRT manufacturers for an update on stock availability and, where products are affected by supply issues, to explain why.
Needs: “Insufficient” power supply
A Besins Healthcare spokesperson said the company’s current supply of Oestrogel in the UK is “insufficient to meet the extraordinary demand [it] is experimenting”.
The company continues to “receive shipments of Estrogel” and “do everything [it] can manage, increase and expedite supplies to pharmacies across the country,” he said.
Besins expects to secure “significant volumes” of the product “over the coming weeks,” the company told C+D.
These will be “handed over to wholesalers on arrival for distribution throughout the country”.
“The Besins are acutely aware of the impact this is having on patients and understand that they may be concerned about fulfilling their Estrogel prescription,” he said.
“We are committed to communicating any significant supply changes to patients, healthcare professionals and other stakeholders,” the spokesperson added.
Orion: “Unprecedented demand in recent months”
Pharmaceutical company Orion said it was experiencing “supply issues” for Sandrena 0.5mg Gel x 28 sachets, Sandrena 1mg Gel x 28 sachets and Indivina 2mg/5mg tablets “due to unprecedented demand these last months”.
“We expect all products to be back in stock later this month,” a company spokesperson told C+D.
Orion “does everything [it] can manage and increase supplies for the UK,” the spokesperson added, while its European parent company continues to send “regular supplies of all HRT products.”
The rest of Orion’s HRT products, including the Sandrena 1mg Gel x 91 sachet, remain in stock, the spokesperson confirmed.
“Low Stocks” for Kyowa Kirin Products
Although Tostran “is not currently out of stock,” a spokesperson for its manufacturer Kyowa Kirin told C+D that the product was low in stock in “some regions as of March 2022.”
“This was driven by resource availability constraints,” they said, adding that “the stock should return to normal levels in the near future.”
No supply problems for Novo Nordisk, Pfizer, Merck and Novartis
Estradot – provided by Novartis UK – “knows no [..] supply issues at the moment,” confirmed a spokesperson for the manufacturer.
Novartis has “worked closely with DH to identify solutions to meet increased demand, as evidenced by overall market data,” they added.
Novo Nordisk’s products are also unaffected by supply issues at this time, a spokesperson confirmed to C+D.
None of Pfizer’s HRT drugs are impacted by “supply constraints”, a Pfizer spokesperson told C+D.
A Merck Sharp and Dohme spokesperson said “there are currently no anticipated supply issues for Livial”.
Why has demand increased?
Demand for HRT products — such as Besins’ Estrogel Pump-Pack 750 microgram/actuation gel — “increased significantly” in May 2021, a company spokesperson told C+D.
This is partly due to the recent “increased media coverage of menopause”, they added, which “continued throughout the year and intensified further in November” last year after that the government has announced that it will implement longer prescription cycles for HRT products.
Read more: HRT drug Gina 10mcg could become a P-drug after MHRA consultation
An increase in social media posts by women sharing their experiences of menopause and “women demanding better and more equal menopause treatment,” is another factor that Besins says is driving demand.
There has been “increased attention to menopause as a factor for women in the workplace,” the company told C+D.