Oestrogel and prescribing success

[WombatChocolate]

I started on Oestrogel and Utrogestan 3 months ago.

I was due my 3 month review and rather worried that they would only issue another short prescription (meaning hassle of getting further prescriptions, plus double prescription costs each time). I was also worried about the oestrogel shortages.

Before my online appointment I did some groundwork. I phoned local pharmacies (4) to see if they had any oestrogel in stock. One had 4 bottles and said I could have them if I brought a prescription in later today. Additionally I researched online what the equivalents to 3 pumps per day were, in case I needed an alternative item prescribed. I also checked what 3 months and 6 months supply of 3 pumps per day of oestrogel would be, in terms of pump dispensers.

Armed with the info, I had my phone all appointment and handed over my BP reading and talked through the relief I had received from some of my symptoms and fact I had increased from 2 to 3 pumps.

GP clearly in a rush. Said happy to re-prescribe. No mention of quantities. So I asked if I could have 6 months supply to avoid having to keep paying 2x prescription charge. GP agreed that would be okay. GP the. Struggled to know how much to prescribe to give me 6 months supply of 3 pumps….but I knew the number was 640mg or 8 pump dispensers. They then issued by prescription (including 6 packs of Utrogestan) direct to my pharmacy (which I had earlier updated as my chosen place for electronic prescriptions on My Nhs App). I also asked for a generic estraodial prescription so that if Oestrogel suddenly wasn’t available, I could be given Sandrena instead.

I called the pharmacy immediately to check again that they still had 4x Oestrogel and had received my prescription via the electronic spine. They had. I set off and 20 mins later had a bag of HRT and was home.

It felt like hard work and took me quite some time to ring round the pharmacies, update my designated pharmacy and do the research before my GP appointment, but I think it was worth it. Without doing this, And without knowing exactly what I wanted to ask for and precise quantities, I suspect I’d have been given a very small prescription, which would only last me a few weeks on 3 pumps per day. Not only that, but it would have gone to my local and usual pharmacy which tells me they have no gel and do t expect to get any.

my prescription wasn’t 100% fulfilled, as they still owe my 4 bottles of oestrogel, but at least it’s already paid for and I have enough to keep me going for 3 months and by then hopefully supply issues will improve and I can collect in dribs and drabs as I pass by if needed.

Just thought this might be useful to the many who are struggling to get oestrogel. I’d seen here on MN the idea of ringing pharmacies before GP appointment to see what gel stock they have, so the prescription can be made generic or tailored - many thanks. I’d also seen the suggestion to know exact quantities to tell the GP, so that the errors in quantity prescribing are less likely. Combining these 2 together has worked for me this time.

good luck everyone trying to access oestrogel. Given a key symptom of menopause is anxiety, this shortage is certainly making anxiety worse isn’t it!

You are actually lucky your GP agreed to a six month supply! Our CCG and local GP's are all limited to 2 months, for anything, including HRT. They will prescribe 6 months for contraceptive, and some chronic conditions, but that's all. I had a bit of an argument with the dispenser this morning about it. I got two months supply, but had requested three, as I am away in June/July. She was very shirty with me, and when I said I would therefore have to do a re-request after only a month, she basically said "tough shit" you will have to do a special request from the GP's and they may not give it to you!!!! I am actually going to complain, but unfortunately, I think it is a local edict that you can no longer get large prescriptions, as it cost them too much, and the GP's can't claim so much back.

The Mail is on the case :)
www.dailymail.co.uk/news/article-10741575/HRT-crisis-leaving-women-suffering-sleepless-nights-pharmacies-start-run-MP-says.html

Louise Newson has also been tweeting about it for days.

The issue is not that there isn't any but that they need to increase production to meet the new demand.

At the moment they are still manufacturing, but the supplies are being spread across the country owing to increased demand, and the manufacturer has used up all their back-stock to cope.

so each pharmacy gets a small amount or none(depending on which wholesaler they use.)

I still do believe that some pharmacies are not trying hard enough or putting pressure on wholesalers. I don't have proof of this at all, but do know that some pharmacists are better at grabbing stock than others.

I don't know the answer to amounts on a prescription. It seems rather silly that GP practices are going to the bother of providing more prescriptions which uses man power, simply to save money- and does it really save money?

HRT is very cheap. I buy my own as it's private prescription. The cost of gel RRP to the NHS is around £4.50 a bottle.

The NICE guidelines suggest that after the initial 3 month review, 6 monthly prescriptions are to be encouraged.

As I understand it, GPs don’t make money per prescription but pharmacists do.

Given the move in time to yearly prescriptions, insisting people have a new one every 1 or 2 months and given there are 2 prescription charges, is nuts. Some people even report only being allowed 1 bottle if oestrogel over prescription, which if they are on 4 pumps per day, lasts 2 weeks!

In my experience, any chance of getting more comes from direct conversation with the GP, not a nurse or someone else who manages the admin. Mentioning the cost of getting 2 prescriptions every month or 2 and also the moves towards yearly prescribing and NICE guidelines can really help. Clearly, some surgeries or members of some CGPs will be more resistant, but I think some people can have success with this my speaking to the GP and by being very clear about the costs and what they want. Of course, no woman should have to take this approach. Anyone vulnerable or who doesn’t know the systems or know what they want or need or would like to have, is likely to find themselves with less access and paying more prescription charges and facing more inconvenience. It’s always the way with health, but it seems to be even more accute with HRT prescribing at the moment. It’s a disgrace that you have to be a bit sharp-elbowed and to have spent hours on research and phoning round to access the treatement you need and to get it in sensible quantities.

The other thing I asked for during my call today was for it to go on repeat prescription. I just looked and now I am down for repeats, if 8 bottles of oestrogel and 6 packs of Utrogestan. I realise I am fortunate to get this and also that I worked hard to get it. I’m hoping that for me at least, this means that getting HRT will be smoother in future and also that some of this might help other people too.

The big thing I have learned is that whenever I call the surgery, is to not be given a nurse or pharmacy appointment but to insist of a GP. It seems terrible as GP appointments cost more and often someone else SHOULD be able to deal with the issue, but the REALITY in my experience is that with a couple of issues, a nurse appointment or pharmacy appointment hasn’t resulted in the right prescription and then led to multiple phone calls, delays and the eventual need to speak to the GP anyway. Three times I had to have more than 4 phone calls/appointments before the issue was properly sorted, so now I go straight to the GP and seem to get better results. They often seem the only ones who have the authority to issue new prescriptions or to make changes to them. Messages get garbled between people and misunderstandings happen. What a waste to have to take 3 professional’s appointments to get something simple done!