Pharmacists given powers to substitute HRT products facing shortages

A further ten serious shortage protocols have been issued for hormone replacement therapy products, amid ongoing supply issues.
Hormone Replacement Therapy

The NHS has issued ten more serious shortage protocols (SSPs) for hormone replacement therapy (HRT) products, enabling pharmacists to restrict the amount supplied to patients or make substitutions without having to consult the patient’s GP.

Previously, pharmacists were given powers to limit dispensing of some types of HRT to three months, as of 29 April 2022, in an effort by the government to mitigate the impact of ongoing supply problems.

The latest SSPs, published on 19 May 2022, cover Estradiol (Sandrena) 0.5mg and 1mg gel sachets, Estradiol (Lenzetto) 1.53mg/dose transdermal spray, Estriol (Ovestin 1mg cream) 0.1% cream and Estradiol (Oestrogel Pump-Pack 0.06% gel) 0.06% gel.

This means that, if supplies are unavailable when a patient presents a prescription for any of these HRT products, the pharmacist can supply an alternative that is listed in the SSP document without first consulting the patient’s GP.

If the prescriptions request more than three months’ worth of HRT, the SSPs state that supplies are “to be limited to three months’ supply” — including where a substitution is provided.

These rules, which apply to the whole of the UK, will be in place until 19 August 2022.

An exclusive story by The Pharmaceutical Journal revealed that shortages of HRT medicines are being “exacerbated” by some patients being given prescriptions for a 12-month supply.

While several problems have underpinned HRT shortages — which have been occurring since 2018 — one main issue is that demand has risen dramatically, with HRT prescriptions doubling in five years.

Last updated
The Pharmaceutical Journal, PJ, May 2022, Vol 308, No 7961;308(7961)::DOI:10.1211/PJ.2022.1.143779

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