Australian Pharmaceutical Association spokesman and Melbourne pharmacist Peter Guthrie said shortages were difficult for pharmacists, who had to send women back to their GP to get prescriptions for alternative hormone treatments that were in stock at the pharmacy, resulting in additional differential charges and time.
“Many women have expressed frustration that no solution has been given to this issue so far and believe that a similar issue affecting primarily male medicines should not be left unresolved for so long,” he said.
Pharmacists’ union NSW president David Heffernan said the shortages arose from supply chain issues that were evident even before the pandemic.
“The disappearance of one brand of drug means a doubling of the use of other brands of drug,” he said.
Australian Medical Association vice-president Dr Daniel McMullen said the shortages were “frustrating” and forced doctors and patients to think of workarounds. The subsequent change in management strategy impacted the time and energy patients spent running around to different pharmacies.
The Medicines Supply Security Assurance will be introduced from July 2023, requiring manufacturers to hold a minimum four- or six-month supply of key medicines in Australia. Mr McMullen said these stockpiling requirements needed to be tougher.
Among the 423 medicines currently in shortage in Australia are several medications used by women during menopause to treat symptoms such as hot flashes and night sweats.
Menopausal hormone therapy (MHT), also known as hormone replacement therapy (HRT), refers to a variety of patches, creams, pills and devices that replace the estrogen that decreases with age.
The patch-based treatment has surged in popularity over the past five years since its release in 2019. Lancet This paper largely dispels previous concerns about breast cancer risk.
Of the nine brands of HRT patches available in Australia, eight are in short supply and the remaining one is not available on the Pharmaceutical Benefits Scheme (PBS).
The patch has experienced occasional shortages over the years, but Menopause Australia executive director Vicky Doherty said the latest shortage was the longest ever in Australia.
She said it was particularly frustrating that expected dates for supply to normalise provided by medicines sponsors to the TGA had been repeatedly extended, with most MHT brands expecting supply to normalise between mid-June and early August.
“We’ve heard stories of women going from one pharmacy to another who are extremely frustrated and upset,” Doherty said. “Our physician members have told us they’re spending their entire lunch breaks trying to find sources of medication for their patients.”
Doherty believes the shortage is the result of a “perfect combination of increased demand due to research showing the drug’s efficacy, the discontinuation of popular brands such as Climara, and supply chain and market issues.
“This wreaks havoc on women and really impacts their quality of life,” she said.
The TGA was unable to provide data on MHT prescribing given in Australia.
Submissions from several health organisations to a Federal Senate inquiry into menopause, published last month, raised concerns about the availability and cost of MHT.
The comments submitted support that MHT is an effective treatment for menopausal symptoms. Most menopause treatments developed in the past 15 years are unsubsidised in Australia and cost women $50 per month, whereas treatments listed on the PBS cost around $25 per month.
