HRT Taskforce presents recommendations to support future supply

Recommendations are to be taken forward by Department of Health and Social Care to help ensure continued HRT supply meets demand

Forms part of wider work to support menopausal women access the health and care they need and tackle the gender health gap

Action will be taken to make supplies of hormone replacement therapy (HRT) more resilient as Head of the HRT Taskforce Madelaine McTernan presents her key recommendations to support future management of the supply chain.

The recommendations will inform the work of the department and the UK wide menopause taskforce as Ms McTernan has returned to working full time as the Director General of the Vaccine Taskforce as preparation for the autumn booster campaign ramps up.

Improving access to HRT forms part of the government’s wider commitment to tackle the gender health gap, including support for menopausal women. The Women’s Health Strategy, published earlier this year, includes the menopause as a key area.

Access to HRT has improved following decisive actions to increase supply and manage demand including issuing Serious Shortage Protocols on HRT products to limit dispensing to three months’ supply and allow specified alternative products to be supplied if necessary.

Following positive engagement across the supply chain, suppliers have also moved to secure additional stock and expedite deliveries of HRT products experiencing supply issues. Suppliers are building future capacity to support continued growth in demand.

These combined actions have resulted in improvement in supply of products including Oestrogel gel. The number of packs of Oestrogel delivered to the UK in July was double the monthly average for the first quarter this year demonstrating a very substantial increase.

Health and Social Care Secretary Steve Barclay said:

Women’s health is a priority for this government, and we are ensuring everyone who needs HRT is able to access it.

Madelaine’s work and that of her taskforce and the department has been vital, and her recommendations will ensure progress in HRT supply continues.

Core recommendations from the HRT taskforce include:

Continued dialogue with industry both via continuing the successful model of regular industry roundtables as well as individual engagement

Continued use of Serious Shortage Protocols when appropriate to manage shortages as steps are taken by suppliers to increase production

Continued assessment whether NHS formularies may be impacting access to HRT

Taking steps to action these recommendations 12 of the 13 Serious Shortage Protocols (SSPs) in place for HRT have been extended to help provide ongoing stability as HRT products that have experienced supply issues increase stock levels. The department has also established quarterly industry roundtables with key suppliers to ensure continued dialogue and help industry to plan for the future.

Outgoing Head of the HRT Taskforce Madelaine McTernan said:

I am pleased to see the situation with HRT supply is improving across the country. I want to thank suppliers and manufacturers for their engagement and positive action to tackle this serious issue.

I have presented my key learnings on how the department can continue to manage HRT supply and work with the industry as it continues efforts to meet rising demand.

Further recommendations to help ensure continued HRT supply to meet rising demand:

Improved access to data on prescriptions to more easily see where there are shortfalls between HRT packs prescribed and HRT packs supplied by manufacturers; and

Taking lessons from the HRT supply chain work to inform broader medicine supply work

Minister for Women’s Health Maria Caulfield said:

We are taking steps across the board to tackle the gender health gap and ensure women can access the health and care services they need – including access to HRT.

I thank Madelaine and her team and I look forward to taking forward her recommendations as part of the ongoing work of the department.

The taskforce has held two roundtables and has ongoing discussions with key suppliers to understand issues and engage on plans to meet demand.

It has issued Serious Shortage Protocols (SSPs) to restrict dispensing of certain products to three months and allow pharmacists to substitute certain products for alternatives. 

Following a return to good availability, Premique Low Dose is no longer subject to an SSP.  The MHRA, have delivered workshops to ensure manufacturers and pharmacists are aware of guidance to help them manage stock levels and worked with the NHS to understand and communicate the role of formularies (a list of recommended medicines) in terms of access to HRT.

Government has also taken action to reduce costs of HRT. The creation of a prepayment certificate will mean women can access HRT on a month-by-month basis if needed, easing pressure on supply, paying a one-off charge equivalent to two single prescription charges (currently £18.70) for all their HRT prescriptions for a year. This system will be implemented by April 2023.

The Menopause Taskforce, which meets every two months, will continue to tackle issues surrounding the menopause including increasing access to treatment, and ending the taboos and stigmas that still surround conversations about the menopause, including in the workplace.

Dame Lesley Regan has also been appointed the first ever Women’s Health Ambassador for England to support in the implementation of the Women’s Health Strategy and improve women’s experiences of the health and care system in England.