NHS manager Cheryl Young led the call to end the misery of menopausal women scrambling to obtain the medication and patches, telling the Prime Minister: “Sort out this HRT drug mess, Boris!” Mother-of-two Cheryl, 44, has endured harrowing health problems for eight months and said: “Why is it a battle for every single woman who needs this medication? What other condition would you be expected to drive hundreds of miles or fly abroad to get hold of your medication? It’s because people think it’s only HRT or its only the menopause. That’s the difference.”
HRT replaces the hormones women can no longer produce because of the menopause and helps with symptoms such as hot flushes, night sweats, insomnia and erratic mood swings.
Around 360,000 HRT prescriptions are issued each month, but the root cause of the UK shortage is unclear.
Patches and pills began to run low late last year.
Cheryl had a hysterectomy in February to combat debilitating endometriosis pains and went into surgically-induced menopause.
But her gynaecologist gave no hint that she would struggle to get the HRT support she needed to recover.
For three months, Cheryl, of Kettering, Northants, picked up her Evorel Conti prescription at her chemist, but in May she was told there were no more combi patches available in her area.
HRT is vital for women who have surgically-induced menopause to replace the loss of oestrogen, which puts them at a increased risk of osteoporosis and cardiovascular disease.
“The gynaecologist was adamant that I would have to go on to HRT straight away, but there was no inkling that it was even an issue,” Cheryl said.
She was offered alternatives but, reluctant to change to a messy gel or tablets, decided to source the patches elsewhere.
Kettering General Hospital found an online chemist to supply them – at £25 a month.
Cheryl and husband Dave, 45, a network security manager, were able to pay for a private prescription, but thousands of women are not so lucky.
“It’s not fair some women can get it and others can’t because they either can’t afford it or they can’t spend the time searching,” Cheryl said. “I’ve heard of women buying it online and saying, ‘Happy Christmas to me’.
Cheryl’s symptoms worsened in October and her gynaecologist changed the prescription to oestrogen-only patch Estradot.
But she has never been able to obtain the patch and has to settle for an alternative which leaves her skin red and itchy.
“There shouldn’t be a supply and demand scenario,” she said. “The supply should be there like every other drug for every other health condition. Women shouldn’t have to fight for it.”
The British Menopause Society’s website says Estradot, made by Novartis, is available. But online pharmacies say it is out of stock.
Novartis said: “There are global supply shortages of several generic and branded HRT products, which is creating increased demand for others, including Estradot.
“Novartis is supplying as much Estradot stock as possible into our UK wholesalers, which is above the normal expected demand.”
Last month the Daily Express revealed the Evorel Mono, Conti and Sequi ranges from Theramex would not be available until February. And Mylan, which produces Elleste, anticipates production will resume “by the latter second half of 2020”.
Professor Martin Marshall, of the Royal College of GPs, said: “The reasons for these shortages are not clear and are likely multi-factorial, but they need to be sorted out as a matter of urgency. They are causing a great deal of uncertainty, inconvenience and distress for patients.”
The issue has been blamed partly on increase in demand for patches, rather than gels or tablets, and a result of multiple manufacturers having problems at the same time. Recent reports suggest the issue may have arisen because the Government added a number of HRT products to a Category C drugs tariff – which determines how much the NHS will pay pharmaceutical contractors – in June 2018.
Category C drugs are low-price branded medicines not as readily available as generic medicines and the repricing is thought to have deterred pharmaceutical companies from selling to the UK.
But the Department of Health and Social Care said the tariff addition was “completely unrelated”. It added: “The problems affecting some HRT products are being caused by manufacturing, regulatory and commercial issues outside of our control and are affecting global markets.
“We understand how distressing the HRT shortage is for women who need these medicines and want to reassure them we are doing everything we can to ensure they can access them as soon as possible.”
