Utrogestan capsules - supply issues

[starlilly88]

I can't find these anywhere, one Boots said they might get some end of November. I need to try and talk to my GP again but does anyone know of an alternative, or what happens if you stop taking them? I have been on oestrogel, about to switch to patches which I can get

My local pharmacy and my GP pharmacy both tell me there is a limit on how many their supplier will provide/pay for. This limit is capped no matter how many prescriptions are issued. Apparently they did this a year or so ago with oestrogen patches. So it’s a lottery and luck if you happen to put your prescription in when a delivery has just arrived. So NHS spend is being restricted on HRT. I suspect to ‘encourage’ users to buy it privately instead. (Can you imagine the - quite rightly - public and media outrage if this was for a cancer drug?) Perhaps no coincidence that it coincides with the government’s announcement to cap prescription charges for HRT. They want to appear to be helping, but the budget holders don’t want to foot the bill. Contacting your MP and making your views known might be a good idea!

To be honest, I didn't know the utrogestan supply problem was still dragging on, as Besins seemed to make out it was a temporary thing and all would be well again in February, more demand, means more manufacture needed, what's going on? Sorry you are having problems.

I hope that is a "worse-case-scenario-fear" and not actually real, because, as I am on benzodiazepines and utrogestan is cross tolerant, a "stock-issue" could literally mean a life threatening situation for me, so I best not worry.

You need them to oppose oestrogen if you have a womb though.

God that's awful

I knew about the cap but hadn't considered the reasons being as such.

I assumed there's currently a finite supply so they make sure its distributed evenly across the country and areas.

I know besins were building or starting a new factory in France for gel.

Belgium sorry!

www.pharmacymagazine.co.uk/news/hrt-manufacturer-to-step-up-oestrogel-production-with-new-site

I have no idea about allocation on a limited basis, to pharmacies, but if so, wouldn't that be the same for all drugs?

Surely independent pharmacies can order whatever they want to because they pay for the drugs and get an NHS reimbursement per prescription.

My pharmacy said: stock is added daily by the manufacturers. The pharmacies can only order what’s in that day. If all stock is ordered one day, they try the next day. So no stock one day doesn’t mean there’s no stock at all, just that the pharmacy needs to keep trying (hard!) to order.

This absolutely ties in with what I was told. (Pharmacy at a private clinic.) They had a list of women waiting and said they were calling the supplier every morning. Once the big batch was released by Besins around 6 weeks ago, they were able to get supplies.

I read somewhere online that at the time (around 4 weeks ago) Besins released something like 200,000 (not sure if that is each capsule - 30 in a pack) or 200K packs.

Maybe it's scaremongering. I know things are bad out there but...

Thanks for this, hopefully this stock issue will be over soon.

Unless I have got something wrong somewhere, capping doesn't make sense.
The more utrogestan Besin's manufacture, the more money they make, same for other hrt suppliers and products. - Sorted 🙂

@Flower1970 What exactly is this 'capping'?
I have never, ever heard of this. I can understand how in theory, if a wholesaler had 1000 boxes of Utrogestan, they might deliver 100 to 10 pharmacies, so each had some, just to be fair. But there is no 'limit' on how many a pharmacy can order, I assume. If there was, it would apply to all drugs.

Many pharmacies are owned by one large company- eg Lloyds - but there are smaller independent pharmacies, owned by the pharmacist, and pharmacies in private hospitals, and they surely can source what they need?

My own situation was I was told that there was none to had anywhere (supplies evidently ran out before Christmas.)

When Besins gave the date of the next batch ( around 21st Feb) many pharmacies were able to order but it took a few days for them to be delivered. The wholesalers have to load the product onto a system, then it can be ordered.

I think it may be a case that some are just not on the ball and don't phone daily to try to get a delivery.

I

I haven’t read this whole thread but just rang my pharmacy to place an order, they’re attached to my surgery in the midlands, and I have never ever had to worry before but they are struggling with both evorel and there is NO UTROGESTAN and she hasn’t been able to get it for a month. She told me she was told: there’s none in the country. That’s todays update. I then went to Newson who initially put me on it and I stay with just for testosterone, and thank god, and they have it with no issues and I could order 3 months. I’m on day 4 of a pack now so I’ll have 4 months to worry and hope this doesn’t get worse. I’ve written to my MP, I suggest everyone does this. I know it’s a pain but if we don’t put huge pressure on them, it won’t be resolved. I really really encourage everyone to write letters, go to MP surgery hours, write to the manufacturers directly ( I’ve done this before ) and don’t stop until they completely and finally resolve the HRT issue. It is ridiculous it has gone on so long but we all must get active to force this change, don’t rely on celebrity pressure please. Please be as active as you have energy for.

NO UTROGESTAN and she hasn’t been able to get it for a month. She told me she was told: there’s none in the country

She's either not being honest or ignorant.

The big delivery came into the UK on the 20th Feb. It was supposed to be the 13th (this was on Besins website.) But they updated that to say it would be a week later.

That ties in with my experience. I was calling the pharmacy in the clinic weekly and a few days after the 20th they called me to say it was in stock.

I'd be querying why your pharmacy didn't place an order a month ago.

They may have done and run out? She said she’s been trying for the last 3-4 weeks so could it be possible that it ran out quickly? Especially as from this thread it seems like it’s definitely hard to get right now. We are in a small rural area so she has 3 patients on it only. I last ordered in January I think it was and it was no problem then.

@WarriorN I understand your worries as they are mine too, but It's nothing to do with MPs- it's supply and demand. The company can't increase production overnight. There are very strict processes to implement in order to increase production including sourcing the raw materials, to the manufacturing, including leaflets and boxes from other suppliers. Some pharma companies even out-source raw materials like purified water than they have transported across the country. Every aspect of a drug has to be examined by quality assurance, from the minute the raw material arrives at the warehouse, and eventually signed off by the quality assurance manager before it leaves to manufacturer (and they don't work 24/7.)
Upscaling this by 100% or more is not going to happen quickly.

no It’s not going to happen quickly but this has been ongoing for some years hasn’t it? Since 2018? With them only addressing it recently by creating a task force and tsar? So I really can’t say I understand why it’s taken this long. If Estrogen was in short supply in 2018 and had to be increased, then so would progesterone.

It hasn't gone on for years.

I've used it for 9 years and it's only Dec/ January that I heard of any issues, when I was coming close to needing my next batch.

There were no issues with gel either in 2018. Off and on there have been a few minor issues, that were to do with the production of the pumps (some issues with some part of the pump.)

I'd got my previous supply of Utrogestan in August last year and there were no problems at all.

Well I read reports and here’s an article from 2019 saying it started in 2018.

https://amp.theguardian.com/society/2019/aug/24/hrt-shortage-uk-women

I appreciate you personally may not have had issues but the issues affected a lot of women well before Dec/Jan. Utrogestan may not have had an issue till now, but in general HRT has had issues for years and there doesn’t seem to be a proper explanation or any kind of information on how much prescriptions have risen and how quickly. If this is the reason, a proper explanation including figures would need to be given to convince me this wasn’t completely avoidable.

The shortage then was with Estradot and maybe another estrogen patch that went out of supply for various reasons. That's gone on for years (I know someone who used it) I think at the time it was stated that there was an issue with the adhesive on the patches owing to a supply problem from overseas. There was a knock on effect as women moved to other patches.

There are also many other drugs that are proving hard to source right across the board, not just products for women.

It's in the pharma industries' interest to upscale production- why would they not want to?

I didn’t say they didn’t want to. But they haven’t done it at a rate that means women aren’t abruptly stopping all over this country. Either because our government haven’t been updating them regularly enough or some other reason. But it needs explaining because it has gone on a long time.

These issues have switched from one type to another, so they have been ongoing, continuously since 2018.

From August 2019

https://www.europeanpharmaceuticalreview.com/news/97582/hrt-shortage-in-uk-expected-to-continue-until-next-year/

‘A shortage of hormone replacement therapy (HRT) in the UK has led medical experts to call for a resolution. According to the experts, the shortage is causing difficulties for thousands of women.Approximately half of the most commonly prescribed HRT products are currently out of stock in many pharmacies. Doctors have also reported that the therapies were becoming difficult to prescribe. Evorel and Elleste, two of the most popular products, have been affected by the shortages. Issues reportedly began in 2018 when the supply chain in China faced problems, causing some manufacturers to cease making HRT patches. This resulted in rising demands for other brands, which in turn became scarce.’

I mean I don’t want to argue, mostly because this has been a pressing issue for years, documented and much discussed and telling women it hasn’t seems a bit silly.

@Whaeanui I'm not arguing either because it impacts on all women.

BUT the link you posted does show that it was an adhesive issue from overseas. For women using patches , the issue wasn't /isn't so bad perhaps as there are other options. There are many brands of patches all with different names but often identical. The press always has an 'angle' and they don't always give the actual facts in their reports.

There are figures out there on the increased demand for Utrogestan and gel. If you see those, it's clear why Besins can't upscale in a short timescale (if you consider how pharma manufacturing works.) You can also read their website where they explain what they are doing to try to resolve it.

And, as I said before, I was told by a friend in pharma that there are many drugs out of stock all of the time and HRT is just one of them.

But it needs explaining because it has gone on a long time.

There is an explanation.

There was an issue with glue/ adhesive for two types of patch in 2019 and that meant women changed to other types.

It's old news.

The latest issue is the huge increase in demand for gel and Utrogestan. And that's down to promotion/ education around meno and HRT.

Read the figures from Besins and you will see why. It's nothing to do with the government.