Women forced to shop around five or more pharmacies to get hormone patches, some missing out altogether - survey
Hormone patches release estrogen into the body in a controlled way, helping to mitigate symptoms of menopause and prevent longer-term illnesses. Photo / 123rf
- Some New Zealand women are now unable to source HRT patches as a long-running shortage worsens.
- A new survey shows the desperate measures patients are taking to source the patches, which are used to manage menopause symptoms and prevent serious health problems.
- Pharmac says it is working on solutions but supply issues will last until next year.
Around one in 10 women who use hormone patches say they are unable to source the menopause treatment at all – even after shopping around multiple pharmacies.
Shortages of the most commonly-used hormone replacement therapy (HRT) patches have become so severe that bulk-buying agency Pharmac has acknowledged some people will now miss out.
In an update on Friday, Pharmac reiterated that supply of Estradot-brand patches remained “very limited” and “some people will not be able to get” the funded treatment. The supply problem was likely to continue until next year, the agency said.
Around 60,000 New Zealand women use HRT treatments, which release estrogen into the body in a controlled way and help to mitigate menopause symptoms and prevent long-term illnesses.
Napier-based GP Dr Samantha Newman, who has a special interest in menopause treatment, began surveying HRT patch users last week to understand the impact of the worsening shortage.
Out of more than 700 respondents in an online survey, 70 per cent said they had been told by their pharmacist they had no patches available. Around 8 per cent had gone to five or more pharmacies before getting hold of the treatment, and 13 per cent were unable to get the medication at all.
“I know one patient had to drive 45 minutes to a pharmacy which had stock and was told ‘Sorry, we’ve run out now’ once she got there,” Newman said.
Newman said in the case of one of her patients, access to HRT medication was a matter of life and death.
“I’ve had an email from one woman who is frightened for her life,” she said. “She was suicidal before her doctor prescribed HRT and now that she can’t get it anymore, she is panicking.”
A patient in Auckland told the Herald there was a waiting list of 80 people at their local pharmacy, and once supplies arrived they would only get a week’s worth of the patches.
Social media is filled with women seeking advice on which pharmacies had supplies of the patches.
“Just won the Estradot lottery,” one Facebook user posted online last week after they obtained a month’s supply of the product.
Emilie Joyal, from Rotorua, said her pharmacist was often out of stock and told her to come back. On other occasions, she was offered a couple of patches with a different dose to “keep her going” until stock was available.
“It is just highly stressful,” said Joyale, who runs advocacy group Surgical Menopause New Zealand.
Joyal said shifting to alternative products carried some risk because they were often not as effective at managing symptoms.
Patients who shifted to alternatives could also face higher bills. Joyale said she sourced an estrogen gel as a “back-up” when patch supplies were low, which cost her $92 a month.
Pharmac senior therapeutic group manager Alexandra Compton said the Estradot shortage was worldwide and the agency was doing all it could to ensure people could continue to access the treatment.
She said Pharmac had worked closely with the supplier and had sourced alternative brands to try to keep up with demand.
“Unfortunately, we have not been able to prevent some supply gaps,” she said.
Some doctors and patients say Pharmac has been slow to respond to the shortage, which dates back to 2020 and was driven by increases in demand and Covid-19-related supply chain disruptions.
Comparable countries like Australia are also facing shortages but have offered a greater range of alternatives to patients, in particular estrogen gels, advocate groups said.
Compton said a procurement process was under way for an estrogen gel for New Zealand patients and more information would be provided next month. Pharmac has also tendered for the supply of HRT patches. Both of these initiatives would increase supply of the medications, Pharmac said, while warning they were not quick solutions and would take time.
Meanwhile, some patients are paying more to get access to the sought-after medication.
Pharmac limits supply to two patches of the same strength a week. Because the usual doses are sometimes not available, pharmacists are dispensing several different doses and some are charging extra for it.
Pharmac has previously said it was reviewing the two-patch limit, though did not directly answer questions about this process and whether the limits might be loosened.
Isaac Davison is an Auckland-based reporter who covers health issues. He joined the Herald in 2008 and has previously covered the environment, politics and social issues.