Desperate women are being forced to pay up to eight times the NHS price for HRT products at private online pharmacies, the Daily Mail can reveal.

MPs last night accused some chemists of ‘exploiting’ women in need of vital supplies, while doctors said firms could be making ‘massive profits’ hiking up prices.

Shortages and poor planning mean thousands have been unable to get treatments to help ease menopause symptoms such as low mood, brain fog and hot flushes.

It comes as the Daily Mail joins our sister paper The Mail On Sunday’s campaign – launched last week – to demand urgent action to tackle the crisis.

Our manifesto calls for pharmacists to be allowed to dispense substitutes if the prescribed HRT is out of stock, an annual payment for HRT and an end to the postcode lottery of approved HRT products,

File photo of a woman taking HRT.  Shortages have been so severe that some women have been forced to spend hours visiting different pharmacies in search of it

File photo of a woman taking HRT.  Shortages have been so severe that some women have been forced to spend hours visiting different pharmacies in search of it

File photo of a woman taking HRT.  Shortages have been so severe that some women have been forced to spend hours visiting different pharmacies in search of it

Oestrogel, which is used by around 30,000 women in the UK, has been in short supply lately, leading to a HRT ¿gold rush¿ as women race to pharmacies to get their hands on dwindling stock

Oestrogel, which is used by around 30,000 women in the UK, has been in short supply lately, leading to a HRT ¿gold rush¿ as women race to pharmacies to get their hands on dwindling stock

Oestrogel, which is used by around 30,000 women in the UK, has been in short supply lately, leading to a HRT ‘gold rush’ as women race to pharmacies to get their hands on dwindling stock

(left to right) Dr Louise Newson, Mariella Frostrup, MP Carolyn Harris, Penny Lancaster and Davina McCall with protesters outside the Houses of Parliament in London demonstrating against ongoing prescription charges for HRT

(left to right) Dr Louise Newson, Mariella Frostrup, MP Carolyn Harris, Penny Lancaster and Davina McCall with protesters outside the Houses of Parliament in London demonstrating against ongoing prescription charges for HRT

(left to right) Dr Louise Newson, Mariella Frostrup, MP Carolyn Harris, Penny Lancaster and Davina McCall with protesters outside the Houses of Parliament in London demonstrating against ongoing prescription charges for HRT

Labour MP Carolyn Harris, co-chairman of the UK menopause taskforce, said: ‘I fully support the Mail’s campaign. It’s high time something was done to improve the lives of thousands of women across the country.’

The MP for Swansea East called on private clinics to ensure treatments were affordable, saying raising prices was ‘exploitative of women’.

FACT BOX TITLE

1. Allow pharmacists to dispense substitutes if the prescribed HRT is out of stock

Currently, if an HRT product is unavailable, a pharmacist cannot substitute another product without consulting the prescribing GP, forcing patients to go back and forth between doctor and pharmacy. This could be avoided if pharmacists are allowed to alter prescriptions themselves. They should also be able to move stock between different pharmacies.

2. End the postcode lottery

Local areas all have different formularies – or lists – of approved HRT products, meaning women face a postcode lottery of treatments. A national list of all approved HRT products would ensure women have equal access, and that alternative treatments are available faster.

3. Immediately introduce the once-a-year payment for HRT medication

An annual prescription payment for HRT, which could save women up to £200 a year, is planned for April 2023. This must be implemented urgently, especially during the cost-of-living squeeze, so all women can afford treatment.

4. Bring forward mandatory requirement for medical students to be taught about the menopause

A curriculum change needs to be introduced sooner than January 2023, when it is planned. This will ensure all doctors have the training to recognise menopause symptoms, which will help reduce the rate of misdiagnoses.

5. Provide menopause information to women at their NHS health check

Everyone who doesn’t have a pre-existing medical condition is invited for a free check-up every five years between the ages of 40 and 74. Women should be given information at these health checks to raise awareness of the menopause and treatment options.

 

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And Jane Pangbourne, founder of the HRT Truth Collective, said: ‘The campaign the Mail has put together seems to be not only timely but also pulls together the key areas in one place.’ Increasing numbers of desperate women are now buying products online at up to eight times the NHS prescription charge of £9.35 – and one online pharmacy has admitted hiking up the prices of some of its popular HRT products.

This has sparked fears that thousands of women could be priced out of crucial treatments just when the cost-of-living crisis bites – meaning there is fast becoming a twin-track approach to accessing HRT treatment.

Last night the Government announced it is rationing some HRT products to a three-month supply to combat shortages.

The move, which will affect Oestrogel, Ovestin cream and Premique low-dose tablets, is the first to address supply issues since the appointment of HRT tsar Madelaine McTernan. Those who have prescriptions longer than three months will not have to pay an extra charge. Health Secretary Sajid Javid said: ‘I want to reassure women I have listened to their concerns and will not hesitate to take decisive action to ensure they can access the HRT they need.’

It comes as the Royal College of Obstetricians and Gynaecologists said it was ‘very concerned’ that women were resorting to online pharmacies, many of which are unregistered and could be ‘unsafe as the medication might be out-of-date, diluted or fake’. Oestrogel, a drug which is used by around 30,000 women in the UK, is particularly low in stock.

While its manufacturer, Besins Healthcare UK, said yesterday it was on track to meet demand in June, there has been a big increase in women seeking HRT, with an estimated 538,000 prescriptions issued in December, compared with 238,000 in January 2017. As a postcode lottery means many are looking online for HRT, some online pharmacies have been found to be selling a three-month supply of Oestrogel for £80.

Prices vary wildly, however, with Oxford Online Pharmacy selling the same product for £49.99.

Pharmacy Planet is rationing its sales of Oestrogel to one-month batches due to ‘limited stock’, but at £42 each.

Alternatives to Oestrogel have also taken a hit as women switch to different medication until stocks are replenished.

Treated.com is selling one month’s worth of Estradot patches for £32, although women can normally get a three-month supply for £9.35 on the NHS.

The Independent Pharmacy prices a three-month supply of Estradot and Sandrena – an Oestrogel alternative – at £75 each.

There is no suggestion these online pharmacies, registered with the Care Quality Commission, are handing out unsafe medicine.

Private prescriptions are not subsidised by the NHS and so are typically more expensive, while pharmacies say overheads and online consultation costs are also factored in. But the wholesale cost for most HRT drugs is usually between £5 to £10.

There were about 512,000 NHS prescriptions written for 'female sex hormones and their modulators' in England in February, the latest official data shows, compared to 265,000 in March 2017. Many of these will be HRT medications but some may include other female hormone drugs such as contraceptives

There were about 512,000 NHS prescriptions written for 'female sex hormones and their modulators' in England in February, the latest official data shows, compared to 265,000 in March 2017. Many of these will be HRT medications but some may include other female hormone drugs such as contraceptives

There were about 512,000 NHS prescriptions written for ‘female sex hormones and their modulators’ in England in February, the latest official data shows, compared to 265,000 in March 2017. Many of these will be HRT medications but some may include other female hormone drugs such as contraceptives

Haitham Hamoda, chairman of the British Menopause Society, said there appeared to be ‘a massive margin of profit’. He added: ‘Private pharmacies can argue and say it’s their overheads and it’s not subsidised, but why would you need to put that much overhead on what you’re providing?’

James Batson, of Pharmacy Planet, admitted the firm had increased prices for some HRT products ‘around eight weeks ago’ due to rises in wholesale costs. He added: ‘The pricing of our service reflects the true costs that have been incurred.’

A spokesman for The Independent Pharmacy said it maintains ‘a fair market rate’, and Treated.com said prices ‘include a consultation with a UK-registered clinician, dispensing by our UK-regulated pharmacy, next-day delivery and follow-up care from our clinical team’.

Hormone Replacement Therapy Q&A 

How does HRT work?

Hormone replacement therapy eases symptoms including brain fog, disturbed sleep and hot flushes by replacing hormones that are at a lower level as women approach the menopause. HRT can come in the form of patches, tablets or gels which are available on prescription through the NHS.

How much does it cost?

A single NHS prescription charge costs £9.35, or £18.70 if a woman needs two types of hormones. This is often provided on a short-term basis, meaning regular payments – once a month, or every three. The Government has pledged to make annual prescriptions available, but this won’t be implemented until next April. Many have now resorted to buying HRT for up to eight times the NHS price online.

Why is there a crisis?

NHS England data shows that prescriptions for HRT have more than doubled in five years following an increase in campaigning and media coverage. Besins Healthcare – which makes Oestrogel, used by 30,000 women in the UK – has expressed ‘regrets’ that ‘extraordinary demand’ has led to shortages. Other products have been affected as women switch to alternatives.

What can be done?

The British Menopause Society has advised women struggling to find Oestrogel to discuss other products with their GP. However, some experts have noted that women are often on a particular HRT regime that is specifically tailored to their needs.

Can the pharmacist help?

If a pharmacy is out of stock, a patient must first be referred back to their GP to be given a prescription for an alternative. The Royal Pharmaceutical Society has called for pharmacists to be able to make minor changes to a prescription to provide a suitable alternative. In addition, patients face a postcode lottery as pharmacies often cannot share stock with each other.

Is it dangerous to swap your HRT medicine?

Medical professionals have warned that sharing or swapping HRT products could lead to ‘serious side effects’ that can be debilitating, not least because different products will have different dosages. Trading with others also could mean accidentally using out-of-date medicine.

When will the crisis end?

Besins has said it is doing ‘everything we can’ to increase supplies to wholesalers and pharmacies across the country. The company said it is on track to meet growing demand in June.

What are ministers doing?

The Health Secretary has appointed an HRT tsar to help tackle the crisis. Madelaine McTernan, the woman responsible for securing Covid vaccines for the UK, will lead efforts to address shortages. Sajid Javid said he will leave ‘no stone unturned’ to make sure women get the HRT they need.

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Seven months hunting for my gel 

By Samantha Brick for the Daily Mail 

For the last seven months, Leigh Campbell’s life has revolved around ‘chasing’ her prescription for HRT.

‘Each morning the first thing I do is look on the Boots website to see if they have the gel in stock. One day I drove around 14 pharmacies,’ the 46-year-old psychotherapist said. ‘I work with women who feel suicidal when they walk of the GP surgery without their HRT.’

Miss Campbell first experienced menopausal symptoms, including heaving bleeding, insomnia and joint pain, when she was 41.

‘Even though I was told by my GP I was too young to be peri-menopausal, I went private and was prescribed Oestrogel. Within 24 hours my symptoms stopped. I felt like me again.’

After being unable to get hold of Oestrogel last September, Miss Campbell found the alternative treatment didn’t effectively treat her symptoms. ‘Even on the maximum dosage my peri-menopausal symptoms returned… I couldn’t work for eight weeks.’ By February this year, Miss Campbell, from Northern Ireland, was offered an alternative gel, but she added: ‘I’m chasing my prescription constantly.’

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