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HRT shortage: pharmacists call for change

With significant supply shortages and prescription delays, millions of women dealing with symptoms of menopause are struggling to access the treatment they need.

The Royal Pharmaceutical Society (RPS) has called for a relaxing of laws and regulations surrounding the prescriptions of hormone-replacement therapy (HRT) in the UK.

Currently, pharmacists must dispense the exact product and amount of medication to patients prescribed HRT treatment. A substitute cannot be given without consulting the GP who prescribed the medicine, often leading to delays for patients trying to access their treatment. HRT is also facing significant supply chain issues and struggling to cope with increased demand, which is further exacerbating the issue.

Impact on patients

These supply issues are not exclusive to HRT treatments. A survey by the Pharmaceutical Services Negotiating Committee suggests medicine supply chain problems are a daily issue for pharmacies – affecting two-thirds of the 5,000 premises representatives they spoke with. Anger from patients is being directed to pharmacy staff across the UK, who claim they are facing abuse and aggression from patients frustrated when they cannot get their medication or treatment. Ambitions to greatly improve access of treatments for patients is a key component of the Government’s Life Sciences Vision and an identified area for significant progress to be made.

However, supply chain issues and delays of access for HRT treatments is particularly a problem for women going through menopause, with some reporting feeling suicidal without access to their treatment.

Millions of women in the UK experience menopause symptoms such as hot flushes, low mood and anxiety – with the psychological impact of menopause gaining greater attention. Despite Davina McCall’s campaign to cut prescription costs and increase access for HRT, demand for treatments still far outweighs supply with prescriptions more than doubling since 2017. To alleviate patients needing their treatment, the Government needs to examine ways in which access can be maximised whilst maintaining safety in the prescription process.

RPS President, Professor Claire Anderson said: “Difficulties in accessing HRT unfairly impacts women, affects their mental health and worsens health inequalities.”

Speaking further on the laws and regulations for prescription access, she adds: “one solution would be to enable pharmacists to make minor changes to a prescription when something is out of stock. This is faster for patients and more efficient for the NHS.”

Government response

Maria Caulfield, Patient Safety Minister, said the Government was taking action to speak with suppliers following a recent surge of demand. She added that she herself held meetings with trade associations that deal with HRT suppliers directly.

Ms. Caulfied asserts: “they’re confident they’ll get supplies back to the demand levels that we need but we don’t want to leave any stone unturned so we’re bringing in a lead on HRT supply so if there’s anything the government can do to help suppliers we’re in a position to do so.”

She added that while the demand for HRT has risen recently, the COVID pandemic has made some ingredients difficult to source and there have been challenges around the world, not just in the UK.

Health Secretary Sajid Javid also has announced that he will be appointing an HRT tsar, a taskforce modelled on the Covid-19 vaccination response, to help improve supply in both the short and long term.

However, the response of the Government was met with criticism from opposing MPs, highlighting that the reforms did not achieve enough for patients suffering from the current supply chain issues. Labour MP Carolyn Harris, co-chair of the UK menopause taskforce, welcomed the HRT tsar but highlighted the reforms were coming too late for women already failing to get access to their treatment. “Women deserve better” she added.

Final thought

Supply chain issues and prescription regulations are severely impacting women in menopause, who rely heavily on HRT treatments. As millions of women are currently impacted by these symptoms, the Government has rightly responded to the surge in demand for HRT. However the nature of the issue is widely applicable to other patients, frustrated with access to their prescribed medicines and treatments.

Improving access to treatments should be a high priority as the Government looks to achieve its ambitious targets for the life sciences sector and improve health outcomes across the board. For further information, see our NHS Innovation and Life Sciences Commission.

The reforms outlined by Ms. Caulfield and Sajid Javid’s show promise that the government is responding to the issue, but further action is needed to address those continuing to deal with the supply issues today.

Photo credit: freestocks.org

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