Stuff Digital Edition

Patchy HRT supply upsets patients

Catherine Hubbard

Shortages of a commonly used hormone replacement therapy (HRT) medication have left women ‘‘outraged and angry’’, a pharmacist says.

Estradot, a medication administered through a patch on the skin, has had supply issues for more than two years. An alternative brand brought in to help ease supply in July, Climara, has run out.

Globally, the shortages have been blamed on ‘‘extraordinary’’ increases in demand for HRT.

Switching to another brand, Estraderm, has caused some women to break out in hives or rashes and experience more hot flushes, according to women posting on an online menopause support group.

Christchurch woman Rachelle Crosbie has been able to avoid having to switch brands so far – if her 100-microgram dosage wasn’t available, her pharmacist made it up by combining 75mcg and 25mcg patches.

‘‘He’s aware that different brands may not work as well for his customers,’’ Crosbie said. ‘‘I’m stable on Estradot. I don’t want to risk that changing since I’m in surgical menopause, which can be harder.’’

A Nelson pharmacist said women were ‘‘outraged’’ and ‘‘angry’’ when they learned that their usual patches were not in stock. HRT was a very commonly prescribed medication.

Menopause podcaster Penny Ashton said while Pharmac wasn’t in a position to do much about the shortage, it would be ‘‘very hard’’ for some women whose symptoms included panic attacks and insomnia. ‘‘For some people, the thought of going back to that would be terrifying.’’

It was costly to see menopause specialists – if you could even get an appointment. ‘‘So to go through all of that and then to suddenly not be able to get it [HRT] I can see would be quite stressful for people.’’

GP and menopause doctor Linda Dear said Estraderm was OK for some, but in her experience the patches were baggy, didn’t stick as well as Estradot, and many more women had allergic reactions to the adhesive. She told her patients whose patches were loose or falling off to change them every two days rather than twice a week, to ensure they were ‘‘getting a nice stable dose’’.

Pharmac only funded twiceweekly patches, she said, so pharmacists would supply more than that, but women would have to pay to be able to change them more frequently.

While the issue was a global one, the problem in New Zealand was that there wasn’t much else to choose from, she said. There was no other non-oral estrogen available, such as gels or sprays, and not every dosage of every brand was funded.‘‘We need to move beyond patches really.’’

Health professionals and advocates who talked with Stuff were, however, sympathetic to Pharmac, acknowledging that not every drug could be funded and that the shortage was a global issue.

Pharmac’s chief medical officer Dr David Hughes said Estradiol TDP Mylan was available and Pharmac had secured alternative brands to ensure people had access to funded treatment.

National News

en-nz

2022-12-03T08:00:00.0000000Z

2022-12-03T08:00:00.0000000Z

https://fairfaxmedia.pressreader.com/article/281616719392628

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