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Pharmacists tell health secretary of potential solutions to HRT supply issues

Pharmacists have shared their views on “wider solutions” to address the supply issues that are affecting hormone replacement therapy (HRT) products during a meeting with the health secretary.

Sajid Javid and the newly appointed HRT tsar Madelaine McTernan met with representatives from the supply, wholesale, and community pharmacy sectors yesterday (May 5), to discuss how to ease supply issues with HRT products.

Pharmacists present at the meeting shared their experience on the frontline and their thoughts on solutions including “improved communications”, the Department of Health and Social Care (DH) wrote in a statement yesterday (May 5).  


Action to “improve near-term situation”


The meeting firstly focused on identifying “what action can be taken swiftly to improve the near-term situation”, Ms McTernan said.

Those present also discussed what “longer-term changes [would be needed] to ensure these key products can continue to be delivered reliably and efficiently”, she continued.

Key HRT manufacturers, including Aspen Pharmacare, Besins-Healthcare, Gedeon Richter, Novartis, Novo Nordisk, Orion, Pfizer, Theramex and Viatris, were also present.

Each “outlined the steps they’re taking to boost supply” of products, some of which have been in short supply over the past few months due to “rising demand”, as well as “manufacturing [issues], capacity constraints and commercial decisions”, the DH wrote.

Mr Javid said yesterday that the government “will leave no stone unturned in our national mission to boost supply of HRT”.

“We are working collectively with the sector to urgently resolve this issue,” he said yesterday.


AIMp’s suggested solutions


Association of Independent Multiple pharmacies (AIMp) member Sandeep Dhami, superintendent at MW Phillips Chemist in Birmingham, and the organisation's chair Peter Cattee also attended the meeting yesterday.

AIMp CEO Leyla Hannbeck told C+D today (May 6) that during the meeting, the organisation “highlighted the significant amount of time and effort pharmacists on the frontline spend to source out products for their patients and the stress this puts on pharmacy teams and patients and other parts of the healthcare system”.

While manufacturers say that there are no supply issues affecting medicines and HRT products, “when ordering medicines through wholesalers, pharmacists regularly get out of stock messages”, Dr Hannbeck said.

“This suggests that while supply may be there, perhaps there is a supply chain problem,” she added.

“AIMp is therefore calling, as we have done previously, for complete transparency in the supply chain and we are asking the government and the DH to look into this.”


SSPs alone won't solve HRT issues


Dr Hannbeck also suggested that the pre-payment certificate for HRT products – which is due to be launched in April 2023 – should be brought forward.

In addition, pharmacists should be allowed to supply an alternative to medicines that are out of stock, although Dr Hannbeck argues that this alone would not address HRT issues because “as soon as a product is substituted, the other product goes out of stock”.

Finally, the organisation endorses “the implementation of a national formulary rather than the current local formularies which cause inconsistencies in supply in various parts of the country”, Dr Hannbeck said. 

“Last Monday, in an interview with Channel 4, AIMp called for better planning and communication between the government and all parties involved in the supply chain and we are pleased that our call was heard by the health secretary and this meeting was arranged to find a way forward,” Dr Hannbeck added.

Last week, the DH issued serious shortage protocols for Oestrogel, Ovestin cream and Premique Low Dose, to allow community pharmacists to limit the supply of these products to three months, according to the protocol rather than the written prescription – thus removing the need to seek authorisation from the prescriber.

The General Pharmaceutical Council also warned online pharmacies not to increase the prices of HRT  products “in a way that is unjustifiable”, after Labour MP Carolyn Harris claimed that some online pharmacies are “profiteering” off current HRT product shortages by selling treatments for up to “three times as much as they’re worth”.

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