Oestradiol (Estradot) patches: Supply issue
There is a global supply issue affecting oestradiol patches.
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27 June 2024 Update
A new brand of patches will be funded from 1 July 2024. We don't have delivery dates yet for the new patches, but we will provide an update when we can.
What is happening?
Supply of all oestradiol patches is very limited. The availability of patches can change rapidly and varies around the country. We’re anticipating that some people will not be able to get oestradiol patches.
We want to acknowledge the stress this supply issue may be causing. We are taking every measure to ensure that people can continue to access this treatment.
When will this be fixed?
Unfortunately, this situation will continue through 2024 and likely for some time into 2025.
What is Pharmac doing?
Pharmac and the supplier have been sourcing alternative brands of patches to try to keep up with demand. Unfortunately, we have not always been able to prevent supply gaps.
We recently tendered for the supply of patches. The annual tender invites bids to supply the New Zealand market and helps us understand our options for ongoing supply, we’ll release more information about this when we have a confirmed supplier from our tender.
We also called for proposals (RFP) from suppliers for oestradiol gel. We aim to provide more information on this proposal in July for your feedback.
Request for Proposals – Supply of oestradiol gel
These two initiatives should provide better supply of the treatments people need to live well. Neither the tender nor the RFP are quick solutions and will take time to implement. In the meantime, Pharmac is working closely with many suppliers to find and fund alternative brands of patches.
Over the course of this supply issue Pharmac has been:
- 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
- asking suppliers and wholesalers to limit patches they send out trying to make distribution of the limited stock as fair as possible
- supporting suppliers to speed up delivery of stock into New Zealand and out to wholesalers and suppliers.
Costs to people using patches
Patch limit
Pharmac funds a maximum of eight patches of each strength per month. Your pharmacist may need to dispense more than 8 patches of the same strength to ensure you get the right dose, but you will need to pay extra.
You will need to ask your pharmacist what the cost will be. Pharmac cannot control the private market for medicines. Each pharmacy will have its own approach to charging to cover costs for these patches.
We understand the frustration having to pay extra may cause. Pharmac has not lifted the patch restriction because of concerns about running out of the lower strength patches more rapidly.
We are exploring options that could help with supply issues for oestradiol patches, including reviewing the restriction. However, we need to carefully consider this alongside available supply to make sure we don’t do anything that could make the situation worse. We are constantly reviewing and monitoring the situation and working with our suppliers to see what we can do.
Needing a new prescription for repeats
You may be asked to get a new prescription instead of being able to pick up a repeat, this may happen if the pharmacy needs to change the strength of patch they are dispensing. There is an issue with the software pharmacies have to use to claim funding from Health NZ which means that they cannot change patch strength between repeats. Health NZ is working to correct this. We appreciate your patience on this issue.
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. The Pharmacy Guild is working with 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.
Why is this happening?
Demand for patches in New Zealand has more than doubled over the past few years, growing from around 1.3 million patches in 2021 to 3 million in 2023. We expect demand to continue to grow.
This issue is global. Australia is also experiencing issues with supply of oestradiol patches, similar to New Zealand.
International suppliers are also reporting extraordinary increases in demand for oestradiol patches. As a result, they are building up their production capabilities. However, they continue to experience challenges in meeting this increasing demand.
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.