HRT shortages made worse by long-term prescribing, says PSNC 

Exclusive: Mike Dent, director of pharmacy funding at the Pharmaceutical Services Negotiating Committee, said that demand for HRT prescriptions is outstripping supply more than previously, following the announcement of changes to prescription charges.
Woman applying oestrogen gel on her hands

Shortages of hormone replacement therapy (HRT) medicines are being “exacerbated” by some patients being given prescriptions for a 12-month supply, the Pharmaceutical Services Negotiating Committee (PSNC) has told The Pharmaceutical Journal.

Mike Dent, director of pharmacy funding at the PSNC, also said the year-long prescriptions were resulting in “extra workload” for pharmacy teams owing to them having to go through supplier quota override processes and carry out staged dispensing.

“We are aware of some difficulties obtaining some HRT drugs, such as Oestrogel [Besins Healthcare],” he said.

“Demand for HRT prescriptions is currently outstripping supply following the announcement of changes to HRT prescription charges and recent media coverage regarding HRT supply issues.

“We have also begun receiving reports from contractors seeing prescriptions for 12 months’ worth of HRT, which is exacerbating the situation.”

In a statement given to The Pharmaceutical Journal on 25 April 2022, Dent said that “early indications” from the PSNC’s ‘Pharmacy Pressures Survey’ showed that many pharmacies were having to deal with medicine supply issues on a daily basis, sometimes leading to aggressive behaviour from patients unable to get hold of vital medicines.

“Pharmacy staff are spending hours talking to different suppliers, other pharmacies and GPs to try to help patients, and this is adding to their already unmanageable workloads,” he said.

Following ongoing HRT shortages, which have been reported since 2018, health secretary Sajid Javid told the Mail on Sunday on 24 April 2022 that he intends to create an HRT ‘tsar’ to oversee problems associated with prescribing and dispensing the treatment.

Responding to the health secretary’s comments at the time, Claire Anderson, president of the Royal Pharmaceutical Society, said: “I look forward to working with this new champion for HRT and the government on how we can better support women’s health, building on the positive move to reduce prescription charges for HRT for women. But the government should now go further and end unfair prescription charges for patients in England altogether.

“With continued concerns from patient groups about medicines supply for people with other conditions, this appointment must be part of a wider government strategy to ensure patient access to medicines,” she added.

On 16 March 2022 — while giving evidence to the Women and Equalities Committee as part of its inquiry into ‘Menopause and the workplace’ — pharmacy minister Maria Caulfield said the government was looking into a scheme to introduce a single prepayment of £18.70 for a year’s supply of HRT, but anticipated that it would not be in place until April 2023.

In the meantime, Caulfield said that guidance from the National Institute for Health and Care Excellence said that GPs could issue 12 months’ worth of HRT to their patients after an initial three-month period, which would involve just one payment.

Read more: HRT prescriptions more than double in five years, despite shortages

Last updated
The Pharmaceutical Journal, PJ, April 2022, Vol 308, No 7960;308(7960)::DOI:10.1211/PJ.2022.1.140211

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