Decision to fund Estradot as an alternative brand of oestradiol patches
What we’re doing
Two brands of oestradiol patches – Estradiol TDP Mylan and Estradot will be funded from 1 December 2025. People will be able to use either brand of patch, subject to availability.
There is a global supply issue affecting the Estradot brand of oestradiol patches. This is because the factory that makes Estradot cannot make enough to keep up with increasing global demand.
Pharmac has secured as much Estradot as the supplier can provide. However, there may be times where there is not enough Estradot for everyone who needs it.
This is why Pharmac will fund two brands. The supplier of Estradiol TDP Mylan has assured Pharmac that it can produce enough patches to meet demand in New Zealand.
Any changes to the original proposal?
Pharmac released consultation on this proposal on 27 March 2025. No changes to the proposal have been made.
Proposal to fund Estradot as an alternative brand of oestradiol patches
We received over 1,100 responses to our consultation. The majority of the feedback was supportive, with people telling us how important funding the Estradot brand is to them. Some people were not supportive of our proposal as they did not want the Estradiol TDP Mylan brand to be funded as well. Other people wanted more brands funded as well as Estradot.
People also asked us to consider removing the patch limit and change the dispensing rules to change the quantities dispensed from monthly to three-monthly amounts. We acknowledge this is frustrating for people. The current restrictions on quantity and dispensing frequency will however remain at this time due to ongoing supply uncertainties while demand continues to increase. We will review these restrictions in 12 months depending on the supply outlook.
We understand a lot of people are interested in how we make our decisions. The paper which was considered by the Pharmac Board to make this decision, is now publicly available.
Who will be most interested
- People who use, or may use oestradiol patches, their partners, friends, family and whānau
- Healthcare professionals
- Groups who support and advocate for people with menopause and for women’s health, gender affirming care, and osteopenia
- Community pharmacies and the people that work there
- Health New Zealand | Te Whatu Ora
- Pharmaceutical suppliers and wholesalers
Detail about this decision
For people who use oestradiol patches
There will be no changes to the funding of currently listed brands of oestradiol patches between now and 30 November 2025.
The main funded brands of oestradiol patches are changing to Estradiol TDP Mylan (supplied by Viatris) and Estradot (supplied by Sandoz).
This means that, from 1 December 2025, everyone who uses funded oestradiol patches will need to use either the Estradiol TDP Mylan or Estradot brands. Estradiol TDP Mylan and Estradot will be the only funded brands of oestradiol patches from 1 December 2025. We understand most people are already using these brands.
There will be enough Estradiol TDP Mylan for anyone who wants to use it.
Estradot continues to be affected by a global supply issue. Internationally and in New Zealand there has been a large increase in demand for oestradiol patches and demand is expected to keep increasing. These increases have meant that the factory that makes Estradot cannot make enough to keep up with increasing demand. Pharmac has secured as much Estradot as the supplier can provide. However, there may may be times where Estradot will not be available for everyone who needs it. We estimate that there will be enough Estradot patches for around half of people currently using oestradiol patches.
If after talking with your prescriber, the Estradot brand is considered the best treatment for you, you would need to talk to them and your pharmacist about its availability and alternative treatment options.
We will provide regular updates on oestradiol patch shipments on our website. Please note that there will likely be some delay between a shipment arriving and stock being available for you to collect from your pharmacy.
For pharmacists
From 1 December 2025, there will be two funded brands of oestradiol patches: Estradiol TDP Mylan and Estradot. There will be no specific eligibility restrictions on either brand of oestradiol patch.
There may be times where Estradot will not be available for everyone who needs it. We expect that there will be enough Estradiol TDP Mylan for anyone who wants to use it. Pharmacies will need to stock both the Estradiol TDP Mylan and Estradot brands of oestradiol patches in order to ensure there is enough stock for everyone.
To manage availability of Estradot, pharmacists will need to consider dispensing the Estradiol TDP Mylan brand for prescriptions, unless Estradot is specifically requested by the individual or prescriber. This will help manage the availability of Estradot.
A brand switch fee will apply to the Estradiol TDP Mylan brand from 1 December 2025 until 28 February 2026.
The current restrictions on quantity and dispensing frequency will remain at this time due to ongoing supply uncertainties while demand continues to increase. We will review these restrictions in 12 months depending on the supply outlook. We acknowledge this is frustrating for people.
Our website will be updated with regular updates on stock shipments. Consumer information will be available on our website and through Healthify. Pharmacists have told us that printed consumer information would also be helpful. We are happy to supply these, and pharmacies will be able to order them through a portal. These resources will be available in the coming months and available on our website.
For prescribers
From 1 December 2025, there will be two funded brands of oestradiol patches: Estradiol TDP Mylan and Estradot. There will be no specific eligibility restrictions on either brand.
There may be times where there is not enough Estradot patches for everyone who needs to use them. We expect that there will be enough Estradiol TDP Mylan for anyone who wants to use it.
So that there is enough stock of Estradot for the people who need it, we are asking you to consider prescribing:
- the Estradiol TDP Mylan brand of oestradiol patches to people starting treatment.
- the Estradiol TDP Mylan brand of oestradiol patches to people who are already using it without concern.
- the Estradot brand of oestradiol patches for people who need it.
Other oestradiol products such as oestradiol gel (Estrogel), which may be used for menopause hormonal treatment, remain funded and available. We will provide regular updates on stock shipments on our website. Consumer resources will be available on our website in the coming months.
Schedule changes
From 1 December 2025, Estradot and Estradiol TDP Mylan will be the only funded brands of oestradiol patches on the Pharmaceutical Schedule. From 1 July 2025 new prices and subsidies will apply to both brands in Section B and Part II of Section H of the Pharmaceutical Schedule, as follows:
|
CHEMICAL |
FORMULATION |
BRAND (SUPPLIER) |
PACK SIZE |
CURRENT PRICE AND SUBSIDY |
NEW PRICE AND SUBSIDY |
|---|---|---|---|---|---|
|
Oestradiol |
Patch 25 mcg per day |
Estradot (Sandoz) |
8 |
$14.50 |
$16.23 |
|
Oestradiol |
Patch 50 mcg per day |
Estradot (Sandoz) |
8 |
$14.50 |
$15.79 |
|
Oestradiol |
Patch 75 mcg per day |
Estradot (Sandoz) |
8 |
$14.50 |
$16.53 |
|
Oestradiol |
Patch 100 mcg per day |
Estradot (Sandoz) |
8 |
$14.50 |
$16.18 |
|
Oestradiol |
Patch 25 mcg per day |
Estradiol TDP Mylan (Viatris) |
8 |
$9.85 |
$8.89 |
|
Oestradiol |
Patch 50 mcg per day |
Estradiol TDP Mylan (Viatris) |
8 |
$10.75 |
$9.26 |
|
Oestradiol |
Patch 75 mcg per day |
Estradiol TDP Mylan (Viatris) |
8 |
$11.88 |
$10.33 |
|
Oestradiol |
Patch 100 mcg per day |
Estradiol TDP Mylan (Viatris) |
8 |
$12.95 |
$10.59 |
Estradiol TDP Mylan will be the Principal Supply Brand of oestradiol patches from 1 December 2025 until 30 June 2027. Estradot will also be listed on the Pharmaceutical Schedule without additional eligibility restrictions.
All other brands of oestradiol patches will be delisted from 1 December 2025.
What you told us
Thank you to those who took the time to give feedback. A summary of the main themes raised in feedback and our responses to the feedback received are below.
|
Theme |
Pharmac Comment |
|---|---|
Supportive of funding Estradot as an alternative brand |
|
|
Relief that Estradot would continue to be funded. People told us this proposal would positively impact their lives by helping them manage symptoms effectively. Families, partners and friends shared similar feedback. One brand does not suit everyone, and choice is very important. For example, Estradot is the best brand for some people and for others the best brand is Estradiol TDP Mylan. Funding more options would help to reduce financial costs for changing medications or new prescriptions, and the need for multiple GP appointments. |
We understand there are different lived experiences for people who use oestradiol patches. We are pleased to have progressed a proposal which would meet the health needs of New Zealanders. |
Restrict Estradot stock |
|
|
Concern about Estradot not being available at times. Estradot should be funded only for certain people (e.g. those who can’t use other funded treatment options including Estradiol TDP Mylan patches and/or oestradiol gel). |
We consider that applying access criteria to Estradot would create additional barriers for people requiring Estradot. This would also result in substantial resource burden on the health sector (e.g. the need to apply for Special Authority approvals). To help manage the availability of Estradot we plan to target communications to pharmacists and prescribers about using the Estradiol TDP Mylan brand for people who are able to use it. |
|
Concerns that Estradiol TDP Mylan is less effective at managing symptoms for some people. Some people also reported that the adhesive on the Mylan product wasn’t effective, causing the patch to fall off. |
Both products are approved by the medicines regulator, Medsafe. The reference product for Estradiol TDP Mylan is Estradot. In principle, this means that both products should work in the same way for most people; however, we recognise that this does not appear to be many New Zealanders’ lived experience. This proposal would mean that people can choose the brand of oestradiol patch that works best for them when there is supply of both options. |
|
Estradot should be subject to a part charge. Some responders considered that there was no clinical reason that Estradot should be used over other brands, other than patient preference. |
We have heard from people that while different brands of patches should work the same, this is not everyone’s experience. In order to ensure that there is equitable access to Estradot, we have not put a part charge on Estradot. We plan to communicate to prescribers and pharmacies to reserve use of Estradot for those who are unable to use or tolerate Estradiol TDP Mylan. |
Dispensing restrictions |
|
|
Frustration about having to pick up a dispensing from their pharmacy each month, and request for three month’s supply at once. If a pharmacy does not have a particular brand when someone is due for their repeat, people often then pay for a new prescription to go to a different pharmacy to find the brand they need. |
We acknowledge the frustration from having to visit multiple pharmacies to find stock and/or paying for new prescriptions. We consider that the need for this will reduce with the new supply arrangements. Unfortunately, at this time we are concerned that if we applied three monthly dispensing that this could impact the supply of Estradot. We consider it is important for usage patterns to stabilise before we make any changes that could affect supply. We plan to revisit this request in 12 months’ time. By this time, we anticipate usage patterns should have stabilised with the new supply arrangements. |
|
The limit of two patches of each strength each week is too restrictive for people requiring more than 200 mcg per week, or people who require a dose made up of more than two patches. Funding limits should be aligned with total dose and clinical need. |
The patch restriction applies to each of the four strengths of patch. Therefore, someone could be dispensed more than 200 mcg worth of funded patches per week; however, this would consist of many patches and may not be a suitable option. We consider that changing or removing the limit at this time would put further pressure on the demand of lower strength patches, in the instance of a supply disruption with Estradot. This would increase the risk of these patches not being available and more people would not have access to Estradot. We will revisit this in 12 months’ time. If a strength of Estradot was unavailable, options could include:
We have received a funding application for access to an unlimited amount of oestradiol patches for gender dysphoria among male-to-female transgender people. The next step in our process is to seek clinical advice from our expert advisors. |
Fund more than two brands |
|
|
People would like funded access to other brands, particularly when Estradot is unavailable if people cannot tolerate Estradiol TDP Mylan. E.g. Currently funded Estradiol Sandoz or Lyllana brands. We also heard that Sandoz’s other brand of oestradiol patch ‘Estradiol Sandoz’ did not work for some people. |
The agreement we have negotiated with Sandoz requires Sandoz to bring in as much stock as it can supply, which is approximately 50% of the market demand. With this contract in place and certainty of supply with Estradiol TDP Mylan, risk of supply issues with Estradot should be minimised. We also plan to communicate with health care professionals about the need to reserve Estradot for those who are unable to use the Mylan brand, to prevent people who need it most from missing out. At this time Estradot and Estradiol TDP Mylan are the only brands of patches fully approved by Medsafe for use in New Zealand and we have not included ongoing funding for these other brands in our approach. In addition, if there were more brands listed this could create further supply risks with Viatris and Sandoz as they would have less certainty of the levels required to be manufactured. |
Implementation |
|
|
Regular updates about availability of stock are important. Updates could be available via email, website or directly from a pharmacist or prescriber. |
Pharmac has access to information about when new stock arrives in New Zealand. This information may not accurately reflect what is happening in each community pharmacy, as it can take time for stock to work its way through the supply chain. We will provide updates about the availability of stock on the Pharmac website. The webpage will include information on shipments; however, it may not reflect a “real time” picture of stock availability in community pharmacies. |
|
Education about menopause hormone treatments, including brands and patch alternatives (e.g. oestradiol gel) is important. |
Pharmac will work with health sector providers to develop educational resources about this decision for both healthcare professionals and consumers. These will be available in the coming months and available on our website. |
|
The availability of multiple brands of oestradiol patches may create confusion among healthcare providers regarding appropriate product selection and patient management. Request Pharmac provide comprehensive and practical educational resources for healthcare professionals regarding the different brands of patches. |
Pharmac will work with health sector providers to ensure there are resources available to support healthcare professionals regarding appropriate product selection and patient management. These will be available in the coming months and available on our website. We will also look at providing further educational support as part of longer-term actions to assist healthcare professionals in supporting patients, including those from high needs communities. |
|
There has been a considerable level of counselling required from pharmacists about oestradiol patches and this would continue with ongoing supply restraints. Request that community pharmacies be compensated for their time. |
A Brand Switch Fee on the Estradiol TDP Mylan patch will be in place from 1 December 2025 until 28 February 2026 to support pharmacies. |
Fund more treatments for menopause |
|
|
Request funding of other treatments including other brands of oestradiol gel, testosterone, oestrogen and progesterone combination patches, oestradiol implants, progesterone pessaries, and oestradiol spray. |
We currently fund one brand of oestradiol gel as a result of a competitive process for principal supply of this product. There is plenty of stock available in New Zealand. We have received a funding application for testosterone cream for the treatment of hypoactive sexual desire dysfunction (HSDD) in postmenopausal women. This was considered by PTAC in November 2024. The application was recommended for decline. It was then considered by the Reproductive and Sexual Health Advisory Committee in March 2025, the record for this meeting will be available online at a later date. Application Tracker – testosterone cream(external link) We have not received funding applications for oestrogen and progesterone combination patches, oestradiol implants, progesterone pessaries, or oestradiol spray. We would welcome funding applications for these products, should there be a relevant product approved, or under consideration by Medsafe. |
|
Viagra (sildenafil) is funded for male sexual dysfunction and there are not shortages of supply. This was highlighted as a gender inequality. |
Sildenafil is currently only funded for male sexual dysfunction due to spinal cord injury; it is not funded for male sexual dysfunction from any other cause. Sildenafil is also funded for people living with Raynaud’s phenomenon and pulmonary arterial hypertension, both groups being any gender. |
If you have any questions about this decision, you can email us at enquiry@pharmac.govt.nz; or call our toll free number (9 am to 5 pm, Monday to Friday) on 0800 660 050.