Proposal to fund Estradot as an alternative brand of oestradiol patches
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What we’re proposing
Tell us what you think about our proposal to fund both the Estradot and Estradiol TDP Mylan brands of oestradiol patches from 1 December 2025.
If the proposal is approved, Estradot and Estradiol TDP Mylan would be funded without eligibility criteria. This means that people would be able to use either brand of patches for any relevant use, subject to availability.
Global supply issue
There is a global supply issue affecting the Estradot brand of oestradiol patches. This is because the factories that make Estradot cannot make enough to keep up with increasing demand.
There may not be enough Estradot for everyone
Pharmac has secured, through this proposal, as much Estradot as the supplier can provide. However, there may be times were there is not enough Estradot for everyone who wants it.
Patch restriction
We are proposing that the current restriction of two patches of each strength per week would remain. This is because of concerns about running out of the lower strength patches faster if a higher strength patch experiences a supply issue.
Two brands to ensure patches are available
This is why we are proposing to have two brands funded. The supplier of Estradiol TDP Mylan has assured Pharmac that it can produce enough patches to meet the demand in New Zealand.
Have your say
We are consulting on this proposal until 22 April 2025. Once a decision is made by the Pharmac Board, we will release a notification to let you know the outcome. We anticipate this happening in June 2025.
We understand a lot of people are interested in how we make our decisions. We will consider all consultation feedback we receive to help inform any further changes we need to make to the proposal before we make a decision. The final proposal and all consultation feedback will be provided to the Pharmac Board to make a final decision. Once a decision has been made, we will proactively release relevant decision documents.
All the currently funded brands of oestradiol patches will continue to be funded as we work through this.
Why we’re proposing this
In November 2024, Pharmac decided to fund Estradiol TDP Mylan oestradiol patches as the main funded brand.
Pharmac changes brand of funded oestradiol patches
Ensuring patches were available
We made this decision to resolve the supply issues with oestradiol patches. As the supplier of Estradiol TDP Mylan assured Pharmac that it could produce enough patches to meet the demand in New Zealand.
Oestradiol (Estradot) patches: Supply issue
We heard your voices
When Pharmac notified the decision, we received a significant amount of feedback about the importance of having multiple brands of oestradiol patches available. This feedback highlighted that while different brands of patches should work the same, this is not everyone’s experience.
People also shared that they felt like they weren’t consulted on the change and that it caused a lot of distress. We are sorry for that and have learnt some valuable lessons from this.
What you told us
After hearing this feedback, we started work to review the decision. We met with many individuals who use oestradiol patches, as well as pharmacy groups, menopause specialists, doctors, and nurses. They told us:
- The profound impact that the oestradiol patches supply issue has had on their lives or the lives of those they care for.
- Their personal experiences with menopause, highlighting how it affects their daily lives, and the significant, life-changing difference oestradiol treatment has made for them.
- The anxiety they feel about losing access to the brand of patches that works for them.
- Their frustration that, even though different brands of patches are supposed to work the same, that has not been their experience.
Our response
In response to this feedback, we have secured provisional agreements with the supplier of Estradot (Sandoz New Zealand Limited (Sandoz)) and Estradiol TDP Mylan (Viatris Limited (Viatris)).
We are now proposing to continue funding Estradot as an alternative brand alongside Estradiol TDP Mylan. We’re grateful to both suppliers for their collaboration and work to support New Zealanders.
We look forward to continuing to work with you
We value the input and advice from our communities, and we will be meeting again with representatives to discuss the details of this proposal. We will also read and consider all the feedback we receive. This feedback will tell us whether we need to make further changes to the proposal before we make a decision. When we have a final proposal, we will present the proposal to the Pharmac Board to decide.
Who we think will be interested
- People who use, or may use oestradiol patches, their friends, family and whānau
- Healthcare professionals
- Groups who support and advocate for people experiencing menopause and for women’s health.
- Community pharmacies
- Health New Zealand | Te Whatu Ora
- Pharmaceutical suppliers and wholesalers
What would the effect be?
For people who use oestradiol patches:
Between now and 30 November 2025, there would be no changes to the funding of currently listed brands of oestradiol patches.
From 1 December 2025, there would be two funded brands of oestradiol patches:
- Estradiol TDP Mylan, supplied by Viatris, and
- Estradot, supplied by Sandoz.
If this proposal is approved, there would be enough Estradiol TDP Mylan for anyone who wants to use it.
Supply of Estradot is limited
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 over the last few years 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 would not be available for everyone who wants it. We estimate that there would be enough Estradot patches for around half of people currently using oestradiol patches.
Work with your prescriber
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. Estradot may not be available at all times.
For pharmacists:
From 1 December 2025, there would be two funded brands of oestradiol patches: Estradiol TDP Mylan and Estradot.
No eligibility restrictions
We are not proposing to apply specific eligibility restrictions on either brand of oestradiol patches. This is because we consider that applying access criteria to Estradot would create additional access 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).
Estradot may not be available
There may be times where Estradot would not be available for everyone who wants to use them.
We estimate that there would be enough Estradot patches for around half of people currently using oestradiol patches. It is possible that the number of people who want to use Estradot may increase as the total number of people using oestradiol patches continues to grow.
Stocking both brands
Pharmacies would need to stock both the Estradiol TDP Mylan and Estradot brands of oestradiol patches in order to ensure there is enough stock for everyone. We expect that there would be enough Estradiol TDP Mylan for anyone who wants to use it.
Managing demand for patches
To manage availability of Estradot, if this proposal is approved pharmacists would need to consider dispensing the Estradiol TDP Mylan brand for prescriptions written generically, unless Estradot is requested by the individual or prescriber. This would help manage the availability of Estradot for people who need it.
We would provide regular updates on stock availability of both brands. We are interested to hear from you about how you would like to receive these updates.
Patch restriction
We are proposing to keep the restriction of two patches per week on each strength of oestradiol patches. This is because of concerns about running out of the lower strength patches faster if a higher strength patch experiences a supply issue. This restriction prevents people from making up a higher dose by using multiple lower strength patches and ensures that people using lower strength patches have access to the patches they need.
For prescribers:
From 1 December 2025, there would be two funded brands of oestradiol patches: Estradiol TDP Mylan and Estradot.
No eligibility restrictions
There would be no specific eligibility restrictions on either brand.
This is because we consider that applying access criteria to Estradot would create additional access 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).
Patch restriction
We are proposing to keep the restriction of two patches per week on each strength of oestradiol patches. This is because of concerns about running out of the lower strength patches faster if a higher strength patch experiences a supply issue.
Estradot may not be available
There may be times where there is not be enough Estradot patches for everyone who wants to use them.
We have secured enough stock of Estradot for approximately half of people currently using oestradiol patches.
It is possible that the number of people who want to use Estradot may increase as the total number of people using oestradiol patches continues to grow.
We expect that there would be enough Estradiol TDP Mylan for anyone who wants to use it.
Prescribing by brand name
To manage the availability of Estradot, if this proposal is approved, please consider prescribing oestradiol patches by brand name.
For people starting treatment with oestradiol patches, or who currently use Estradiol TDP Mylan without concern, please consider prescribing the Estradiol TDP Mylan brand if clinically appropriate.
This would help manage the availability of Estradot for people who need it. Where a brand is not specified on a prescription, pharmacies are able to dispense the Estradiol TDP Mylan brand, unless specified on the prescription.
Stock level updates
We would provide regular updates on stock availability of both brands. We are interested to hear from you about how you would like to receive these updates.
Other oestradiol products which may be used for menopause hormonal treatment remain funded and available – see below.
About oestradiol patches
Oestradiol patches are used to increase oestradiol levels in the body. They are commonly used to manage menopause symptoms and other conditions associated with low levels or a lack of oestradiol.
Oestrogen patches are applied to the skin and slowly release the hormone oestradiol, which is then absorbed into the body. It is common to use oestradiol patches for anywhere between 2 to 5 years to treat menopause symptoms, but this varies with the person.
Demand is high and growing
Currently around 100,000 people use oestradiol patches each year in New Zealand. Demand for oestradiol patches continues to grow quickly – from 2 million patches dispensed in 2021/22 to 5.1 million patches in 2023/24. Demand is expected to continue to increase both here and internationally.
Other funded menopause hormone treatments
Pharmac also funds other medicines used in menopause hormone treatment. These include oestradiol gel (Estrogel, fully funded), oestradiol tablets (Estrofem, partially funded) or oestradiol valerate (Progynova, fully funded). There is plenty of stock of all of these products in New Zealand.
Details about our proposal
From 1 December 2025, Estradot and Estradiol TDP Mylan would be the only funded brands of oestradiol patches on the Pharmaceutical Schedule. From 1 July 2025 new prices and subsidies would apply to both brands, 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 |
Should Viatris gain full regulatory approval, Estradiol TDP Mylan would be the Principal Supply Brand of oestradiol patches until 30 June 2027. However, Estradot would also be listed on the Pharmaceutical Schedule without additional eligibility restrictions.
All other brands of oestradiol patches would be delisted from 1 December 2025.
Patch limit
We are proposing that the current restriction of two funded patches (of each strength) per week would remain (8 per month).
This is because there may not be enough Estradot for everyone, which means that there may be times when some, or all strengths of Estradot are not available.
Making sure people can get the strength the need
We are proposing to maintain the limit to help make sure that people have access to the strength that they need.
We consider that changing or removing the limit would put further pressure on the demand of lower strength patches, which would increase the risk of these patches not being available and more people would not have access to Estradot. We would like to hear what you think of this.
What this means for you
This would mean that if your strength of Estradot was unavailable, your pharmacist could dispense the Estradiol TDP Mylan patches instead, until supply was available again.
It would also be possible for your pharmacist to dispense more than 8 patches of the same strength to ensure you get the right dose, but you would need to pay extra.
We understand the frustration having to pay extra may cause. Pharmac is not proposing to lift the patch restriction because of concerns about running out of the lower strength patches more rapidly.
We don’t anticipate the patch limit to be a barrier to access to the Estradiol TDP Mylan brand, as there would be enough stock for everyone who needs it.
To provide feedback
Complete our online form by 4pm, 22 April 2025.
All feedback received before the closing date will be considered by Pharmac’s Board (or its delegate) prior to making a decision on this proposal.
Your feedback may be shared
When you give feedback on a consultation, your feedback becomes official information that Pharmac holds. Pharmac has legal responsibilities for how we manage this official information, under laws such as the Official Information Act and Privacy Act.
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We will consider your views when assessing whether the feedback has to be released. Tell us if there is anything about your feedback that you would prefer wasn’t released.
If your feedback is proposed for release, then Pharmac will contact you, unless there is a legal reason that we can't.
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