Oestradiol (Estradot) patches: Supply issue
We continue to monitor supplies of oestradiol patches.
On this page
Updated 15 May 2024
Supply status updated.
Supply status
We want to acknowledge the stress this supply issue may be causing some people. We are taking every measure to ensure that people can continue to access this treatment. Unfortunately, this situation is likely to continue through 2024 and likely for some time into 2025.
Schedule listing for all oestradiol patches(external link)
Pharmacists, please check with wholesalers on availability.
Supply update for oestradiol patches 15 May 2024
25 mcg
- Sandoz (supplier of Estradot brand): Two months' supply due in July and another two months' supply due in August.
- Viatris (supplier of other brands): Stock available. Next shipment to be confirmed.
- Estraderm MX 25 (section 29): Some stock is available.
50 mcg
- Sandoz (supplier of Estradot brand): 1 month's supply due end May. Another month's supply due in June and July. A smaller shipment due in August.
- Viatris (supplier of other brands): no stock available - next shipment to be confirmed
75 mcg
- Sandoz (supplier of Estradot brand): 1 month's stock arrived. Next shipment expected late May
- Viatris (supplier of other brands): Currently have 1.5 month's stock available.
100 mcg
- Sandoz (supplier of Estradot brand): 4 months' supply due end May with further shipments scheduled in July and August.
- Viatris (supplier of other brands): Out of stock - One month's supply expected late May.
Information for pharmacists
Changing presentations between repeats
We understand that software limitations have prevented pharmacists from being able to claim on patches when they've had to change presentation between repeats, e.g. from 50 mcg patches to 100 mcg patches.
While the Schedule Rules allow pharmacists to do this, it has not always been practical. Health New Zealand | Te Whatu Ora are working to resolve these claiming issues.
Downloads to support conversations
We understand telling people that they can't access treatment is difficult. We have developed a flyer and a poster which we hope can support conversations with people.
Pharmac says this is available but I can’t get it?
We understand it’s frustrating when we’re saying something is available, but you can’t get it. The information we have about available supply relates to whether the supplier has stock. But we don’t have visibility of the supply chain between the supplier and pharmacies.
It can take 1 to 2 weeks between stock becoming available at the supplier to it reaching pharmacies.
- Pharmacies should talk to their wholesalers for more accurate timings.
- People wanting to fill their prescription should keep in touch with their local pharmacies about when stock might be available.
Sometimes, suppliers or wholesalers will ration the stock they supply, which is called putting it on allocation. They do this when stock is limited, and they want to make sure it’s distributed as fairly as possible.
Oestradiol gel and other products
Pharmac has issued a Request for Proposals (RFP) for the supply of transdermal oestradiol products, that is products that deliver oestradiol through the skin. The RFP closes on Monday 13 May 2024.
This is a significant step in our procurement process.
How Pharmac uses RFPs to secure the supply of medicines and other products
We hope this process will alleviate supply pressures and provide people with a greater range of oestradiol presentations. Once the RFP closes the next step will be to evaluate the bids received and put forward a proposal to fund an oestradiol gel for public consultation. Any funding decisions will be subject to the bids received from suppliers and available budget.
We will continue to secure supply of oestradiol patches to address this supply issue.
About this supply issue
Demand has sky-rocketed
Over the last 3 years demand has more than doubled, demand has grown from 1.2 million patches in 2020/21 to over 3 million patches in 2022/23.
The increasing, rapidly shifting demand means that the supplier needs to continually amend its planning and forecasting to increase orders for delivery to New Zealand, which can take time.
Demand has increased globally
Globally, suppliers are reporting extraordinary increases in demand for oestradiol patches. As a result, they are building up their production capabilities. In addition, to this rapid increase in demand, distribution issues have also complicated supply, due to global and local supply chain disruptions caused by COVID-19.
HRT: inside the complex global supply chain behind a $20bn market - The Guardian(external link)
What Pharmac is doing
Because of the ongoing global supply issues, Pharmac is:
- encouraging our supplier to review their forecasting and demand planning for the New Zealand market
- funding a range of alternative brands of the patches to ensure continuity of supply of this medication for New Zealanders
- exploring if there are other presentations or products we could secure and fund in New Zealand
- keeping Estradot stock on allocation, meaning people can only be dispensed one month of patches at a time to ensure equitable distribution of the limited stock
- where appropriate, providing support for suppliers to help speed up delivery of stock
- prioritising seeking clinical advice on which products would be appropriate for people in New Zealand seeking oestradiol treatment, and
- providing regular updates on our website so that people affected by the short supply of this treatment will have the latest information about its availability and alternatives available.
We understand that there will be people in New Zealand experiencing debilitating symptoms. We're exploring every possible option to help New Zealanders to access the medicines they need.
Thank you for your patience
We want to acknowledge the stress this supply issue might be causing some people. We recommend people contact their healthcare practitioner if they have concerns about their medicine.
Other oestradiol products
At this time we are not aware of any supply issues for oestradiol (branded as Estrofem, partially funded). An unrelated supply issue is affecting the 1 mg tablets of oestradiol valerate (branded as Progynova), which are fully funded, the 2 mg tablets remain available
It is important to note that these are different medicines so will require a new prescription and guidance from a healthcare practitioner.
Who to contact
If you are a prescriber or pharmacist with questions about this supply issue, email enquiry@pharmac.govt.nz
If you use the oestradiol patches, contact your health professional. Pharmac cannot give clinical advice about the best treatments for you.