A new report published by the NHS Business Services Authority (NHSBSA) today (October 26) showed that 10.9 million items were prescribed in primary care for HRT in England in the last full financial year, up 47% from 7.4 million in 2021/22.

It also found that the number of “identified patients” prescribed HRT drugs rose by 29% to an estimated 2.3 million compared to 1.8 million in 2021/22, with “more than twice as many patients” prescribed them in the least deprived areas compared to the most deprived.

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And the data showed that the proportion of HRT prescribing that is exempt from script charges has increased since April 2023 - coinciding with the introduction of the HRT prescription payment certificate (PPC) and “reversing a downwards trend from 2015/16 onwards”.

The most recent data available for this financial year - covering April to June 2023 - revealed that there were three million HRT drug items prescibed in 2023/24 so far.

This is a 597,000 increase (24%) compared to the same period last year, the NHSBSA said.

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The new data also showed that almost 99% of all HRT items in 2022/23 were “female sex hormones and their modulators and preparations for vaginal and vulval changes”.

Estradiol (0604011G0) was the chemical substance with both the largest number of prescribed items at 3.9 million and the largest number of estimated identified patients at 950,000 in the last financial year - up 70% and 61% respectively compared with 2021/22.

In 2022/23, Utrogestan 100mg capsules was the HRT medication with the most prescribed items at 935,000 - more than double the 458,000 it had the previous year - according to the report.  

Shortage concerns

 

The new data covers HRT medications prescribed in primary care and dispensed in the community and does not include data on medicines used in secondary care, prisons or issued by a private provider, the NHSBSA said.

It covers all drugs eligible for the HRT prescription payment certificate (PPC), which was introduced in April 2023, it added.

But it stressed that there is “no singular definition of HRT medications” and that “many other products may be used in the treatment of the menopause that are not included” in the statistics.

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And it said that since medicines can be prescribed for reasons other than their primary therapeutic indication and the NHSBSA does not capture the clinical indication of prescriptions, it “cannot determine the reason that a prescription was issued”.

The report also highlighted “concerns that some women across the UK were unable to obtain their prescriptions due to shortages of HRT products”.

“Many women are extremely concerned about not being able to get access to this vital medication,” it added.

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But it said that “most” of the more than 70 HRT products available in the UK “remain in good supply” and that the “supply position has improved” for the “limited number of products” experiencing “supply issues”.

HRT shortages have plagued patients and pharmacists alike for some time, with the government issuing a serious shortage protocol (SPP) for Utrogestan 100mg capsules in May that expired last month.

And an SSP for Estradot 100mcg patches, issued in August, has been extended until November 3.