The Department of Health and Social Care (DHSC) has issued updated advice on current hormone replacement therapy (HRT) shortages which shows some problems are expected to continue well into next year.

It lists six products that are out of stock on a long-term basis and another three currently unavailable but with more supplies due soon.

The list, which was issued along with a prescribing advice guide, also shows that Evorel products are due to run out in September and October with no new stocks expected until the middle of 2020.

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The DHSC confirmed there were supply problems with a small number of oral contraceptive pills due to manufacturing delays but other types were available.

 

Unprecedented demand

 

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Janssen-Cilag who make Evorel patches, which will start to run out next month, said they continued to face unprecedented demand in part because of a lack of availability of other HRT products and had already diverted stock to the UK from other countries with lower demand.

‘So far this year, demand in the UK has already exceeded that of the whole of 2018 depleting all surplus stock,’ a spokesperson said.

‘As a result, we are unfortunately anticipating a complete interruption to supply across the product range from October 2019, although certain patches may stock out earlier than this date. We are working on a return to full supply by mid-2020.’

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The NHS memo for prescribers advises following British Menopause Society guidance which states that ‘prescribers consider equivalent preparations that provide a similar dose to what their patient is using.’

But the recommendations also published on the Specialist Pharmacy Service website, conclude that: ‘If there is insufficient transdermal estradiol products to meet demand then prioritising their use for women at increased risk of [venous thromboembolism] may have to be considered.’