Pharmacist asked about HRT drug shortage – ‘Will it take a death?’

A Hawke’s Bay GP says women are facing serious physical and mental harm as shortages of hormone replacement therapy (HRT) drugs reach emergency levels.

Dr Samantha Newman launched a national survey on Friday to gather the real-life experiences of HRT users who have been denied access to their regular medication or have a dwindling supply.

Survey responses showed women were unable to work or parent effectively because of the impact, were becoming mentally ill with anxiety, depression and suicidal or physically with sweating, heart palpitations, severe fatigue and joint pain.

“I had an email from a woman who is scared for her life,” Newman said.

“She was suicidal before her doctor prescribed HRT and now that she can no longer take it, she is in a panic. The stories I hear almost hourly are horrific.

“I am deeply concerned about the mental, emotional and physical health of HRT users. Will it take a death before the government acts?”

The global supply of estrogen patches began to run out several years ago, but Pharmac was slow to act, she said.

Pharmac said it was doing everything it could to ensure continued access to patches, but could not prevent several gaps in supply and the situation is likely to continue until 2025.

Dr Newman is calling for urgent action by Pharmac and the Ministry of Health to find other options and provide education and support to all those involved in what they can do.

“We need the government to understand that this medication is not a pleasant choice to take or a lifestyle choice – it’s not a supplement, or a vitamin. It’s a vital drug and without it, people are in agony.”

Consumers are using half of their leftovers or paying high costs for alternatives, she said.

“One woman told us she pays about $200 every two months for the gel,” she said.

“However, since last week, we already know from the business that imports the gel product that its stock is also on the verge of running out.

“The women have nowhere to turn and they have no information and the Ministry of Health, the Pharmacy and the government do not tell them anything.”

It was Pharmac’s job to plan ahead so people would have continued access to their medications, Newman said, questioning why alternatives — including gels, tablets and sprays — weren’t already approved, in place and funded for use.

“Over the gap, Australian authorities have approved alternative patch brands called Estramon and Estradiol until their stocks of the popular brand Estradot are replenished this month,” she said.

Results from the survey will be forwarded to government agencies and David Seymour, Minister responsible for Pharmacy.

“We are doing everything we can” – Pharmac

Pharmac said demand for patches had more than doubled from about 1.3 million patches in 2021 to three million in 2023, and this was only expected to grow.

Therapeutics group senior manager Alexandra Compton said they knew people were unable to use some types of patches as there was a global supply problem.

“We are doing everything we can to ensure that people can continue to have access to this treatment. We have been working closely with the supplier of the estradiol patch. We have sources of alternative patch brands to try to keep in open with the request,” she said.

“Unfortunately, we have not been able to prevent some supply gaps.”

Pharmac had recently tendered for patch supplies and would release more information when a supplier was confirmed, she said.

“Pharmac is undertaking a competitive procurement process for estradiol gel. We are currently evaluating the proposals we have received. We intend to provide more information on this proposal in late July.”

But she admitted they were not quick fixes and the situation was likely to continue until 2025.

Pharmac encouraged people to talk to their healthcare professional about treatments that were available, saying it funded estradiol valerate tablets, estradiol tablets, estradiol and norethisterone tablets and conjugated equine estrogen tablets.