Regulators, manufacturers, pharmacies meet to resolve HRT supply issue

Health and Social Care Secretary Sajid Javid and Madelaine McTernan, head of the HRT supply taskforce, continue to take urgent action to resolve the shortage of HRT medicines by meeting the drug manufacturers and representatives from community pharmacies on Thursday (May 5).

In the meeting, manufacturers outlined the steps they’re taking to boost supply, and pharmacists shared their experiences on the frontline, as well as sharing their thoughts on wider solutions including improved communications.

Aspen Pharmacare, Besins-Healthcare, Gedeon Richter, Novartis, Novo Nordisk, Orion, Pfizer, Theramex, Viatris, and representatives from community pharmacies were part of the meeting.

As the government confirmed its intention to work with industry to do what is necessary to fix the HRT supply issue, Javis said he wanted to understand the issues facing suppliers and what can be done to address them.

“We will leave no stone unturned in our national mission to boost supply of HRT. Along with appointing Madelaine McTernan as head of the HRT supply taskforce to implement lessons learned from the pandemic, and ensuring prescriptions are issued in shorter cycles for now, we are working collectively with the sector to urgently resolve this issue,” he commented.

The Association of Independent Multiple Pharmacies (AIMp) said the meeting discussed 'why we got into this position' and the way forward.

According to AIMp, “The SoS (Secretary of State) emphasized that it was a result of a successful government campaign on increasing awareness of menopause. Manufacturers explained there was unprecedented demand and they have to satisfy the global market.”

AIMp also highlighted the significant amount of time and effort pharmacists on the frontline spend to source out products for their patients and the stress this puts on pharmacy teams and patients and other parts of the healthcare system at the meeting with Javid.

Leyla Hannbeck, chief executive of AIMp, said: “While manufacturers are reassuring us that there is no supply issues of medicines, and HRT, when ordering medicines through wholesalers pharmacists regularly get out of stock messages. This suggests that whilst supply may be there perhaps there is a supply chain problem.”

AIMp believes that pharmacists are well placed to clinically check and substitute to similar alternative products and in the long term the profession should be allowed to do that - but the trade body noted alone will not solve the HRT supply problem because as soon as a product is substituted the other product goes out of stock.

“AIMp is therefore calling, as we have done previously, for complete transparency in supply chain and we are asking the government and the DHSC to look into this. We are also concerned to hear reports that some products are finding their way on to the private market costing the patients almost four times the price,” it said.

The association endorsed the implementation of a national formulary rather than the current local formularies which cause inconsistencies in supply in various parts of the country and said they are pleased to hear that the health secretary has agreed to look into.

“We also would like to see the pre-payment certificate which is due to be launched in April 2023 brought forward. Patients are currently paying each month and asking GP's to write six month prescriptions due to costs, yet current guidance is only to give one month. Last Monday in an interview with Channel 4 AIMp called for better planning and communication between the government and all parties involved in the supply chain and we are pleased that our call was heard by the SoS and this meeting was arranged to find a way forward," said Hannbeck.

Welcoming the government’s move of meeting the industry, Association of British Pharmaceutical Industry (ABPI) chief executive Richard Torbett said: “The shortage of some HRT products is a complex problem, and continued collaboration between Government, industry and the NHS is an important part of the solution.

“Intelligence sharing to determine demand is absolutely crucial, and will allow companies to take action to maintain supply wherever possible.

“Removing restrictions on prescribing of products in local areas could also prevent local variation in care and in prescribing practice, which in turn means medicines are less likely to run out of stock.

“Taken together, this should help smooth supply and demand, and help patients access treatments.”

Madelaine McTernan, head of the HRT Supply Taskforce termed the discussion "collaborative and constructive," adding that it focused on "what action can be taken swiftly to improve the near term situation as well as ensuring longer term changes to ensure these key products can continue to be delivered reliably and efficiently."

Vaccine taskforce director general Madelaine McTernan was recently appointed to spearhead the new HRT supply taskforce, applying lessons learned from the successful procurement seen during the Covid vaccination programme to identify ways to support the HRT supply chain ensuring it can meet both short and long term demand. Additional members of the vaccine taskforce will also be redeployed to support this work as the government doubles down its efforts to ensure women can access high quality menopause treatment, including HRT.