Decision to open access to progesterone

Medicines Decision

What we’re doing

We’re pleased to announce the decision to remove all restrictions from progesterone from 1 December 2022. This will significantly increase the number of people who can access funded progesterone for a range of uses, including for menopause hormone therapy. 

This decision is in conjunction with Pharmac’s annual tender process. The funded brand of progesterone will continue to be Utrogestan, supplied by Pharmaco. 

Who we think will be most interested

  • People who may be treated with progesterone and their whānau
  • Support and advocacy groups with an interest in progesterone
  • Health care professionals
  • Te Whatu Ora hospitals and other organisations who deliver services and support for people, and their whānau who may be treated with progesterone
  • Pharmacies and wholesalers
  • Pharmaceutical suppliers 

What does this mean for people?

Progesterone capsules (Utrogestan, 100 mg) will be funded without restriction, from 1 December 2022. This means that progesterone will be funded for any relevant use. 

Any changes to the original proposal?

This decision was subject to a consultation letter dated 19 May 2022. You can read the notification of the other products included in this consultation on our website. 

As proposed in our consultation letter, all funding restrictions will be removed from progesterone. We can now also confirm: 

  • Access will be widened from 1 December 2022. This timing is to ensure that there is enough stock to meet the demand
  • Stat dispensing will apply. This means that people can pick up three months’ supply all at once (rather than monthly). We’ve done this to help make progesterone more accessible
  • The funded brand of progesterone will continue to be Utrogestan (supplied by Pharmaco). 

We’re really grateful for the time people took to respond to this consultation. We heard how supportive people were about the wide availability of progesterone and we were pleased to hear the positive impacts this decision will have on New Zealanders. 

A summary of the main themes raised in feedback and our responses to the feedback received are summarised at the bottom of this notification. 

Detail about this decision

Access to progesterone will be widened in Section B and Part II of Section H of the Pharmaceutical Schedule from 1 December 2022. There will be no funding restrictions on progesterone, it will be funded for any relevant use. 

Progesterone will be available on stat dispensing from 1 December 2022 meaning that people can have three months’ supply dispensed all at once. 

Utrogestan is Medsafe approved for use as hormone replacement therapy in combination with oestrogen in postmenopausal women with an intact uterus. If progesterone were prescribed for other uses, it would need to be prescribed and used in accordance with Section 25 of the Medicines Act 1981. 

Section 25 of the Medicines Act 1981 on the Medsafe website(external link)

Pharmaco has been awarded the Tender for progesterone (widened access) for the supply of its brand, Utrogestan. The price will reduce from 1 December 2022 and Principal Supply Status will apply from 1 May 2023 until 30 June 2025. 

Chemical name Presentation;
Pack size and type		 Current
pack price		 New
pack price		 Principal Supply brand (Supplier) Date of subsidy change Principal Supply Status date
Progesterone Capsule 100 mg, 30 capsule blister pack $16.50 $14.85 Utrogestan
(Pharmaco)		 1 December 2022 1 May 2023

Our response to what you told us

We’re really grateful for the time people took to respond to this consultation. A summary of the main themes raised in feedback and our responses to the feedback received are available below: 

Theme

Pharmac comment

Overwhelming support, in particular people told us:

  • How menopause impacts their lives and their whānau
  • How access to progesterone would have a positive impact for them and others
  • Funding progesterone would improve access to treatment
  • Current funded treatments have significant side effects. People would be much better served by having the most effective and safest treatment
  • Funding progesterone would meet an unmet health need and improve quality of life and long-term outcomes for people experiencing  menopause
  • This proposal aligns with Pharmac’s Māori Responsiveness Strategy and Strategic Direction
  • This decision would be in the interests of equity in women’s health and shows that New Zealand health services are improving their response to female conditions

We are pleased to confirm this funding decision for progesterone which will have such a positive impact on the health of New Zealanders. This feedback is in line with the clinical advice we have received and what we have heard from the sector.

Feedback regarding implementation support which could be provided to assist in equitable uptake of progesterone, such as:

  • Direct communication to primary care about full funding of progesterone
  • Free funding for menopause (and contraception) consultations for Māori and Pacific people and other communities with high unmet need.
  • Public education about menopause in general
  • Public messaging to consumers in te reo Māori and other languages to reach groups with larger unmet need

We will be developing a programme to help support the use of progesterone once it is fully funded. This feedback will be used to inform our planning and engagement.

100 mg capsules are most suitable for use in Aotearoa. The addition of a 200 mg capsule may also be useful for those on higher doses

This decision would not stop us from funding a higher strength in future. We are open to investigating future opportunities in this space.

We received a range of feedback regarding the use of progesterone for gender affirming therapy.  

We heard from people that gender affirming therapy should be highlighted as a specific indication, to further remove any access barriers for individuals who are transitioning. 

We also received feedback that the use of progesterone is not included in any local or international guidelines for gender affirming hormone therapy.

We understand that there are a wide range of treatments available as part of gender affirming hormone therapy and that there have, and still are, many barriers to access. We acknowledge the need for funded efficacious and safe treatments for all uses, including for gender affirming therapy. 

This decision removes all funding restrictions for progesterone. It is the responsibility of prescribers to practice within their scope and prescribe medicines for relevant use that they and their patient consider safe and appropriate. This would include consideration of clinical guidelines, resources and requirements for the unapproved use of medicines.

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.