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Growing list of HRT shortages exacerbating supply issues, reports show

The latest reports by British Menopause Society (BMS) and the NPA of the growing number of HRT products in short supply have revealed the extent of the issue.

BMS was prompted to produce guidance on the availability of hormone replacement therapy (HRT) products last week (August 9), due to a surge in reports of shortages.

"BMS has been reassured that these are temporary shortages, which pharmaceutical companies and their suppliers are trying to resolve," it said.

"Prescribers can consider equivalent preparations that provide a similar dose to what their patient is using," the charity advised.

According to the charity, the following products are in short supply:

Janssen (see the manufacturer’s response below)

  • Evorel Conti (pack of 24)
  • Evorel Conti (pack of 8)
  • Evorel Sequi (pack of 8)
  • Evorel 25mcg (pack of 8)
  • Evorel 50mcg (pack of 24)
  • Evorel 75mcg (pack of 8)
  • Evorel 100mcg (pack of 8).

Merus Labs

  • Estraderm MX 50mcg (pack of 8).

Mylan

  • Elleste Solo: 2mg oestradiol
  • Elleste Duet 1mg oestradiol and 1mg norethisterone acetate
  • Elleste Duet Conti 2mg oestradiol and 1mg norethisterone
  • Femoston 1mg oestradiol and 10mg dydrogesterone
  • Zumenon 1mg oestradiol and 2mg oestradiol
  • Elleste Solo MX 40mcg transdermal oestradiol – likely to be available later this month
  • Elleste Solo MX 80mcg transdermal oestradiol – likely to be available later this month.
NPA adds to BMS list

The National Pharmacy Association (NPA) provided C+D with an update yesterday (August 14) on the HRT products it is aware are in short supply. This included additional items not in the previous list:

Merus Labs

  • Estraderm MX 50mcg (pack of 24)
  • Estraderm MX 75mcg (pack of 24).

Theramex

  • FemSeven Conti (packs of 4 and 12)
  • FemSeven Sequi (packs of 4 and 12).

The availability of these products can change rapidly and the information it provides members is not exhaustive, the NPA stressed.

Theramex said in April that its HRT patches FemSeven Conti and FemSeven Sequi are not expected to reenter the supply chain until early 2020. C+D has asked the manufacturer for an update on the supply situation.

Shortages prompts more issues

Manufacturer Janssen, which produces the Everol range of oestrogen-only HRT patches, told C+D it expects its stocks to run out "at the end of October", if not sooner.

This shortage is due to "an unusual increase in demand" over recent months, and a "lack of availability of alternative HRT products not produced by Janssen".

"It will not be possible to resupply countries, including the UK, within the timeframe required to prevent an interruption," it warned.

RPS: Pharmacies have been struggling for months

Despite HRT supply issues only recently making national media headlines, pharmacy teams have been struggling for a while to obtain these products, Royal Pharmaceutical Society (RPS) president Sandra Gidley told C+D on Tuesday (August 13).

Ms Gidley – who is also a locum pharmacist – said pharmacy teams do not necessarily know why products are in short supply, and not being able explain this to patients can be frustrating.

Knowing the source of the problem "doesn't necessarily help the patient, but at least [pharmacists] can attempt to explain it and it doesn't look as though you're being completely inefficient", she said.

Can you recognise if HRT is appropriate for a patient in this clinical scenario?

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Have you experienced a shortage of any HRTs?

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