Manufacturers struggle to keep up with growing demand for HRT | Menopause
This is a position most companies would like to find themselves in: booming demand for their products.
But soaring demand for hormone replacement therapy (HRT) among UK women going through menopause has seen some manufacturers fail to keep pace, leading to months of supply shortages and stories of women struggling to sleep or work effectively after being unable to get their prescriptions.
Several HRT drug suppliers describe it as the ‘Davina effect’: the documentary Davina McCall: Sex, myths and menopauseled by the TV presenter, which first aired on Channel 4 in May 2021, causing an immediate surge in demand.
Yet nearly a year later, it shows no signs of slowing down. Demand for HRT products jumped 30% in the month after the release, according to Theramex, a global pharmaceutical company focused on women’s health.
Orders continued to grow throughout the year, climbing 130% in the second half of 2021, according to Tina Backhouse, UK country head of women’s health at Theramex.
Millions of women go through menopause each year, and many experience a range of symptoms, which can be serious, including anxiety, low mood, hot flashes and trouble sleeping.
“As an industry, we have had no warning of [the documentary]”, Backhouse said. Theramex subsequently increased manufacturing of its HRT products, which are made in Germany, but this is under ongoing review.
“Every month we review it and put it back in place. I thought at worst we would have 9-12 months of safety stock in the warehouse and we don’t. But we provide enough.
However, the company, owned by private equity firms PAI Partners and Carlyle, said the increased production required significant capital investment and therefore did not immediately lead to higher profits.
“It is expensive to increase production capacity. You have to take a leap of faith,” Backhouse added. “It’s not like ordering a load of groceries for next week, [the manufacturers] having to source raw materials.
HRT shortages in previous years have been blamed on manufacturing and supply chain issueshowever, the industry says the lack of availability in recent months stems from the growing number of women requesting the products.
The number of HRT prescriptions in England has doubled over the past five years to more than 500,000 per month. As a result, certain products have not been available for periods of time.
Earlier in April, the British Menopause Society warned members and doctors of notable continuing shortages of Estrogel, a gel that contains the hormone estrogen and is applied to the skin.
Its manufacturer, Besins Healthcare, said it had seen “continued extraordinary demand” for the gel in the UK.
The private company, which is headquartered in Brussels, said in a statement that it regretted “the continuing situation regarding the insufficient supply of Oestrogel in the UK”.
Although it delivered almost double the amount of gel – which is produced in France and Belgium – to the UK between January and April, compared to the same period in 2021, the company acknowledged that supplies were sometimes “insufficient”.
“Les Besins are acutely aware of the impact of this situation on patients and understand that they are concerned about the fulfillment of their prescription,” the company said, advising any affected patient to speak to their doctor or his pharmacist.
Besins said it plans to increase production further, so it can supply more product to the UK in the longer term.
According to Dr Paula Briggs, president-elect of the British Menopause Society and consultant in sexual and reproductive health, HRT gels or patches applied to the skin are being prescribed more frequently, as they do not increase the risk of blood clots forming. . Although the risk is small, it can be a side effect of HRT tablets.
HRT producers rarely associate due to commercial sensitivities, even in times of shortage.
Some hope that the government’s appointment of an “HRT czar” to tackle lack of availability will lead to more concerted thinking and collaboration within the industry.
“At the moment, it feels like menopause management is celebrity-driven and the clinical focus isn’t where it should be,” Briggs said. “Anyone nominated must be involved in national organizations and be in collaboration with the royal colleges.”
Briggs is also calling for the availability of HRT products to be standardized across all regions and nations of the UK, whether prescribed in doctors’ surgeries or hospitals, to ensure that patients can access alternative medicines if their usual prescription is not available.
HRT producers do not expect demand to decrease anytime soon. Studies have suggested that between 13% and 14% of British women are prescribed HRT, despite the fact that around 80% have some symptoms of menopause.
“I think in the UK there are a lot of very powerful women in politics and in the media who all hit menopause at the same time and are using their platform to discuss it,” Backhouse said.
Television producers have confirmed McCall’s latest menopause documentary will air in early May. HRT providers are preparing for a further increase in demand.