SSPs for Estraderm MX
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The Department of Health and Social Care (DHSC) has issued two new Serious Shortage Protocols (SSPs) for Estraderm MX 25mcg and 100mcg patches.

Effective from 8 September 2022, SSP035 and SSP036 provide that for every Estraderm MX 25mcg or 100mcg patch originally prescribed, one Evorel 25mcg patch or 100mcg patch must be supplied, respectively. Both SSPs are currently set to expire on 16 September 2022.

SSP035 for Estraderm MX® 25mcg patches

For prescriptions (NHS or private) requesting: Supply permitted under SSP035:
Estraderm MX® 25mcg patches Evorel® 25mcg patches

SSP036 for Estraderm MX® 100mcg patches

For prescriptions (NHS or private) requesting: Supply permitted under SSP036:
Estraderm MX® 100mcg patches Evorel® 100mcg patches


Both SSPs, authorised by the secretary of state for health, have been developed by clinicians and provides pharmacists with procedures to follow in providing either of these suitable alternative products to help reduce the number of patients having to return to their prescriber for a replacement prescription.

DHSC informed that there are no SSPs in place for Estraderm MX 50mcg patches and 75mcg patches – these strengths are not affected by supply disruptions and should continue to be dispensed in accordance with the prescriptions

“The SSP035 and SSP036 only allow substitution of Estraderm MX 25 or 100 patches with Evorel 25 or 100 patches, respectively.”

DHSC said: “The SSPs do not allow pharmacists to double up strengths for example, pharmacists cannot supply 2 x Estraderm MX 50 patches against a prescription ordering 1 x Estraderm MX 100 patches. The supervising pharmacist should ensure that the patient’s prescriber is notified when supplying a patient in accordance with these SSPs.”

“The supervising pharmacist, using their professional judgement determines that swapping the patient to a different brand of a patch would not be suitable for the patient.”

Pharmacists are required to read and comply with the requirements outlined within the individual SSP as published on the NHSBSA website for SSP035: Estraderm MX 25mcg patches and SSP036: Estraderm MX 100mcg patches.

DHSC said: “Reimbursement is for the medicine supplied in accordance with the SSP and not the originally prescribed medicine i.e. in this instance contractors will be reimbursed the reimbursement price for either Evorel 25mcg patches or 100mcg patches. The reimbursement price will account for VAT payment. Supply in accordance with the SSP will result in the following fees being paid to the contractor: One Single Activity fee (currently £1.27); One SSP fee (£5.35).”


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