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Pharmacists can substitute out-of-stock HRT products without consulting GP

Pharmacists can substitute out-of-stock HRT products without consulting GP
By Isabel Shaw
24 May 2022

Pharmacists can now substitute hormone replacement therapy (HRT) products for alternatives if the original prescription is out of stock, as part of a host of new rules aimed at tackling the shortage.

The new measures allow community pharmacists to supply specified alternatives to the prescribed products without needing to seek authorisation from the patient’s GP or the prescribing clinician.

The additional power – granted to pharmacists by the Department of Health and Social Care (DHSC) on Friday – comes as part of 10 new HRT Serious Shortage Protocols (SSPs) involving five medicines.

These are in addition to the three SSPs introduced in April that limit the dispensing of Oestrogel, Ovestin and Premique Low Dose.

The HRT products that may now be substituted if unavailable are Oestrogel, Ovestin cream, Lenzetto 1.53mg transdermal spray and Sandrena 0.5mg and 1mg gel sachets.

The DHSC said: ‘Following positive engagement with pharmacists, the Government has issued further SSPs to allow pharmacists the flexibility to safely offer women substitute high-demand products – Oestrogel, Ovestin cream, Lenzetto transdermal spray and Sandrena gel sachets – with appropriate alternatives, such as transdermal patches, which are in good supply.

‘SSPs restricting prescriptions to a maximum of three months’ supply will also be issued for substitute products, as a precautionary measure to ensure the supply of those substitutes is maintained.’

Health secretary Sajid Javid said the Government was working to ‘ensure HRT is available for everyone who needs it’.

‘Meetings with suppliers are ongoing and we’re taking decisive action to manage HRT supply issues and reduce any delays – this includes issuing further SSPs so that women are able to access the medication they need,’ he added.

The full list of SSPs and the details of what each protocol entails can be found on the NHS BSA website.

Last month, the Government announced that three HRT drugs would be limited to be supplied for three months to mitigate shortages.

These limit pharmacies across the UK to dispensing only three months’ supply of the medications at a time, but do not affect GP prescribing.

SSPs came into force in 2019 through legislation that allows community pharmacists in England to provide appropriate alternatives to patients in the event of serious medicine shortages without having to go back to the patient’s GP for an updated script.

A version of this story was first published by our sister title, The Pharmacist

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