The Department of Health and Social Care has issued 10 more serious shortage protocols for HRT medicines in the wake of ongoing concern about supply levels.

The new SSPs, which were announced on Friday, give pharmacists greater powers to manage the amount that is dispensed or make substitutions when patients present with a prescription for a HRT product that is in short supply.  

This follows the initial announcement for three SSPs on May 3, meaning that there are now 13 active SSPs applying to five medicines: Premique Low Dose 0.3mg/1.5mg modified release tablets; Ovestin 1mg cream; Oestrogel Pump-Pack 0.06%gel; Lenzetto 1.53mg/dose transdermal spray: and Sandrena 0.5mg and 1mg gel sachets.

For four of these products, pharmacists may restrict the amount supplied (if the prescription is for more than three months), substitute specific alternative products that are available such as transdermal patches, or both restrict supply and make a substitution.

However, in the case of Premique tablets the SSPs only give pharmacists powers to restrict the quantity that is supplied.

The DHSC claimed its recent actions on HRT supplies, such as implementing the first three SSPs and appointing ‘HRT czar’ Madelaine McTernan to engage with manufacturers and clinicians, are having a positive impact on availability.

It said that Premique Low Dose has returned to good availability, with the manufacturers of Oestrogel and Ovestin also “taking action to increase UK supply”.

Pharmacy minister Maria Caulfield said: “I am very encouraged by the constructive engagement across the sector and enthusiasm with which suppliers and pharmacists are looking to work with us to meet this challenge.

“Focusing both on measures that ensure we can use stocks most efficiently whilst also ensuring supply is increased is critical”.

Royal Pharmaceutical Society president Claire Anderson welcomed the new SSPs, but added: “The bureaucracy involved in completing the SSP process for each individual patient is quite burdensome for pharmacists and we hope to see the shortage of HRT products resolved as soon as possible under the leadership of the new HRT Czar.

“Ultimately we’d like to see a change in the law which makes the whole process easier and quicker for both pharmacists and patients.”

National Pharmacy Association board member Olivier Picard, who met with Ms McTernan on Friday, said: “We welcome the 10 new SSPs which go some way to tackle the supply disruption, but we continue to press for longer term solutions that would empower pharmacists to use their professional judgement to provide alternative medicines.

“We also want to see progress in relation to pharmacies’ ability to share stock without a wholesaler dealer’s licence in the event of shortages.”