Oestradiol (Estradot) patches: Supply issue
We continue to monitor supplies of oestradiol patches.
On this page
Updated 3 April 2024
There is very little stock of the various brands at the moment. The 50 mcg strength is particularly constrained at the moment. If your usual wholesaler doesn't have a specific strength, try other wholesalers. We acknowledge this is a challenging situation for everyone.
This is a fast moving situation and stock levels will change.
We're working closely with the suppliers to understand demand for this product, which continues to grow, and how they can meet that growth.
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.
Schedule listing for all oestradiol patches(external link)
Pharmacists, please check with wholesalers on availability.
Availability of oestradiol patches 28 March 2024
Stocks in pharmacies and wholesalers may differ from what's shown here. The product is on allocation, which means pharmacies are only receiving a small amount each week. This is to ensure equitable distribution of the limited supplies around the country.
Summary of availability
| Strength | Estradot | Viatris | Mylan | Estraderm MX |
|---|---|---|---|---|
| 25 mcg | low | n/a | ✓ | ✓ |
| 50 mcg | low | ✗ | low | n/a |
| 75 mcg | ✓ | ✗ | ✓ | n/a |
| 100 mcg | ✓ | low | ✓ | n/a |
Detail of availability:
25 mcg
- Estradot (pharmacode 2358840) stock is very low.
- Estradiol TDP Mylan (pharmacode 2601583) is available.
- Estraderm (Pharmacode 2645475) is available.
50 mcg
- Estradot (Pharmacode 2358867) stock is very low.
- Estradiol Viatris (Pharmacode 2661470) is not available.
- Estradiol TDP Mylan (Pharmacode 2601591) stock is very low.
75 mcg
- Estradot (pharmacode 2514346) stock is available.
- Estradiol Viatris (Pharmacode 2661489) is not available.
- Estradiol TDP Mylan (Pharmacode 2605317) is available.
100 mcg
- Estradot brand (pharmacode 2358883) is available
- Estradiol Viatris (Pharmacode 2662418) stock is low.
- Estradiol TDP Mylan (Pharmacode 2661497) is available.
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.
Issues with alternate brands
We have heard that people are experiencing issues with the alternate brands of patches. Medsafe has approved them as meeting standards of safety, suitability, and effectiveness.
Check the relevant information leaflet on the best way to apply the patch. Your pharmacist may also be able to offer more guidance.(external link)
Mylan consumer information sheet - Medsafe [page 3 PDF](external link)
Estraderm consumer information sheet - Medicines UK [page 7 PDF](external link)
The steps for applying the patch for Estradot are not on the consumer information sheet. They are on a separate sheet in the Estradot box. You can read the Estradot consumer information information sheet [PDF](external link) but it doesn't contain application instructions.
Who to contact
For patients, if the application information doesn't help, contact Viatris 0800 168 169 or medinfo_anz@viatris.com - they have a team that can help.
For pharmacists, please report any concerns to Medsafe(external link) about efficacy of the patches.
Oestradiol gel and other products
Pharmac has issued a Future Procurement Opportunity (FPO) for the supply of transdermal oestradiol products, that is products that deliver oestradiol through the skin. The FPO can be found on the government’s procurement site, GETS(external link)
An FPO is the first step in a procurement process.
- Media release: Pharmac indicates interest to fund more oestradiol treatments to relieve supply issue
- Future Procurement Opportunities (FPOs) at Pharmac
We hope this process will alleviate supply pressures and provide people with a greater range of oestradiol presentations. Any funding decisions would be subject to the future 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) or oestradiol valerate (branded as Progynova, fully funded) but 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.