Pharmac opens consultation on oestradiol gel

25 July 2024

Media release Medicines

Pharmac – Te Pātaka Whaioranga is now consulting on a proposal to fund oestradiol gel (branded Estrogel) without restrictions. This means it would be available for anyone who is prescribed it.

Pharmac’s Director of Equity and Engagement Dr Nicola Ngawati says that if approved, more than 18,000 people would benefit in the first year of funding.

About 86,000 people used oestradiol in some form in the 2023/24 financial year. It is primarily used as a hormone replacement for people who don’t produce enough oestrogen. It is most often used as a patch placed on the skin, but it can also be used as a gel or tablet.

“Funding a gel would be a great addition to the treatment options already available and would help alleviate the supply shortages that are causing stress and frustration for a number of people,” says Dr Ngawati.

In the past three years, demand for oestradiol patches has more than tripled - growing from 1.3 million patches dispensed in 2020/21 to over 4.6 million patches in 2023/24. This issue is not only affecting New Zealand – shortages are being experienced in many other countries, including Australia.

“We know that people have been unable to access some strengths of oestradiol patches and our clinical advisors have told us that funding another oestradiol product would be useful,” says Dr Ngawati.

Menopause doctor Linda Dear agreed that funding for alternatives such as gels would ease the supply situation.

“I’m so happy that New Zealanders could soon have the option of a fully funded oestradiol gel. The global supply issues with oestradiol patches have caused huge problems for people who use Hormone Replacement Therapy (HRT). Having the gel as an alternative will mean fewer people will struggle to obtain this often life-changing therapy,” she says.

Following public consultation, a funding proposal will be taken to Pharmac’s Board, or a delegate, for a decision. If approved, oestradiol gel is expected be available from 1 November 2024.

Proposal to fund oestradiol gel and to award Principal Supply Status to Estrogel

Media resources

Audio file | Dr Nicola Ngawati talks about the consultation [MP3, 1.9 MB]

Video file | Dr Nicola Ngawati talks about the consultation(external link)

Questions and answers

What is Pharmac proposing?

Pharmac is proposing to fund oestradiol gel (Estrogel) without restrictions.

Consultation on Pharmac’s funding proposal for these medicines is now open and will close on 15 August 2024. Submit feedback through our online form or email consult@pharmac.govt.nz.

Pharmac has sought advice and information from clinicians and consumer groups to help develop the funding proposal. Feedback from the public consultation will help us identify any issues that need further consideration before we take the proposal to Pharmac’s Board, or a delegate, for a decision.

Who will benefit, and how?

Oestradiol is primarily used as a hormone replacement for people who don’t produce enough oestrogen. It is most often used as a patch placed on the skin, but it is also available as a gel or tablet. It is used by 86,000 people each year.

We’re proposing to fund oestradiol gel without restrictions. This means anyone who is prescribed it will be able to use it.

We understand there is a wide range of people who would benefit from having open access to this treatment, where other forms of oestradiol might not be appropriate or available.

Menopause symptoms

The physical and emotional symptoms of menopause may disrupt sleep, result in lower energy levels, or affect emotional health. There are many effective treatments available, from lifestyle adjustments to hormone therapy.

Osteoporosis

Osteoporosis is a bone disease that develops when bone mineral density and bone mass decreases, or when the structure and strength of bone changes.

It is estimated that, on average, a person can lose up to 10 per cent of their bone mass in the first five years after menopause. Taking hormone treatments soon after menopause can prevent bone loss.

Premature ovarian insufficiency

Premature ovarian insufficiency is when a person’s ovaries stop working as they should before age 40. When this happens, the ovaries don't make the typical amounts of the hormone oestrogen or release eggs regularly.

Hormone replacement therapy (HRT) gives people back the oestrogen that's lacking because their ovaries have stopped working as well as they should.

When will this medicine be available?

If the public consultation identifies issues that require further consideration, the team at Pharmac might need to seek further information and advice.

Following that process, a funding proposal will be taken to Pharmac’s Board, or a delegate, for a decision. If approved, this medicine is expected to be available from 1 November 2024. We will advise if further work is required that changes this timeframe.

Why is there a supply issue for oestradiol patches?

Pharmac knows that people are unable to access some strengths of oestradiol patches and that this may be causing stress for some people.

Demand for oestradiol patches in New Zealand has more than doubled over the past few years. In 2020/21, approximately 22,300 people used the patches, increasing to 84,500 in 2023/24. We expect demand to continue to grow.

The issues we’re experiencing are part of a global shortage of oestradiol patches. This is not specific to New Zealand. Shortages are being experienced in many other countries, including Australia. International suppliers are building up their production capabilities but are finding it difficult to keep up with global demand.

We’re doing all we can to ensure people can continue to access this treatment.

The oestradiol patches supply issue is likely to continue through 2024. We expect that the funding of an oestradiol gel will take some of the pressure off the supply of patches, improving this outlook. We continue to work with suppliers, prescribers, and pharmacists on the issue.

We appreciate that people will feel concerned if they are unable to get their medicines and we are working with suppliers to resolve the supply issues. We encourage people to talk to their pharmacist about availability.

Detail about when we expect new shipments of oestradiol patches is available on our website. Stock levels at pharmacies and wholesalers may differ around the country.

Oestradiol (Estradot) patches medicine notice