HRT prescribing increased by 35% in one year, show NHS data

The number of hormone replacement therapy items prescribed in England increased by more than a third in a year, from 5.8 million items in 2020/2021 to 7.8 million items in 2021/2022.
older woman applying hrt gel to forearm

Prescribing of hormone replacement therapy (HRT) products in England increased by 35% between 2020/2021 and 2021/2022, NHS data have revealed.

The data, published by NHS Business Services Authority (BSA) on 6 October 2022, also showed a 30.5% increase in the number of patients prescribed HRT in England during that time.

The increase in prescribing comes despite shortages of HRT products that have been ongoing since 2018, which pharmacy representitives have said were “exacerbated” by some patients being given prescriptions for a 12-month supply.

Overall, the NHS data show that 7.8 million HRT items were prescribed in England in 2021/2022 — an increase from 5.8 million items in 2020/2021.

In addition, an estimated 1.9 million patients were prescribed HRT in England in 2021/2022, compared to 1.5 million in 2020/2021.

The figures also show that patients living in more affluent areas were almost twice as likely to be prescribed HRT than patients living in the most deprived areas, and a greater proportion of patients from the most deprived areas who received an HRT prescription in 2021/2022 were aged under 60 years, compared to those from the least deprived areas.

In an effort by the government to mitigate the impact of ongoing supply problems, in May 2022, pharmacists were given powers to limit dispensing of some types of HRT to three months or to make substitutions without having to consult the patient’s GP using serious shortage protocols (SSPs).

A report published by NHS BSA alongside the data said: “Access to in-demand products has improved since SSPs were issued to limit dispensing to three months’ supply to even out distribution and allow alternative products to be dispensed, as necessary.

“Suppliers have taken swift action to secure additional stock of HRT products which are experiencing shortages and deliveries of further stock have been expedited,” the report said.

“These actions have increased near-term supply and the supply position has improved. To support continued growth in the longer term, suppliers are taking steps to further build capacity and increase production.”

The latest SSPs, published on 19 May 2022, cover Estradiol (Sandrena; Orion Pharma) 0.5mg and 1mg gel sachets, estradiol (Lenzetto; Gedeon Richter) 1.53mg/dose transdermal spray, estriol (Ovestin 1mg cream; Aspen) 0.1% cream and estradiol Oestrogel Pump-Pack 0.06% gel (Besins Healthcare).

Last updated
The Pharmaceutical Journal, PJ, October 2022, Vol 309, No 7966;309(7966)::DOI:10.1211/PJ.2022.1.160960

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