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[da66]

hi all,
I managed to get 3 boxes of estradot 50mcgs/ 24hr patches, ( could of had more) but, no hassel , no probs , no begging the unenlightened GP, ordered them in the morning picked them up im the afternoon, but... im in SPAIN! bought them without prescription, @19euros per box The hassel in the uk with it all is enbarassing to say the least! Only hope it is all sorted soonest!

I am going to Spain soon Tracey - do you have any advice? Any particular pharmacy chain to try? Do the products have the same names there? Am assuming if I take in an old packet (I'm on Evorel 50) they will be able to find it on their system.

[bear]

Bear - I'm sure there are behind the scenes politics going on but I can't quite understand the significance of any of the links in relation to current shortages of HRT in UK, especially the last 3. I think I'm missing something here?    I agree I am sure there are complex reasons though!

However I don't buy the argument put about generally in the media (eg BBC) that it's all down to Femseven being temporarily unavailable (although granted there must be some effect) - after all HRT products are being discontinued all the time and women shift to something else. Also it would not explain the shortages of Elleste - this must be something to do with that company Janssen who makes both the products (Evorel and Elleste). We have never seen the like of this before. There surely must be another explanation? At least we know that RCOG and BMS are looking into it but whether we will get the whole picture who knows? Could it be to do with Brexit?

When HRT shortages become number two story on Radio 4 first thing and lunchtime and there are spokespeople from RCOG and BMS then it must be serious! However to look on the positive side - see how much publicity menopause and HRT is getting - that can only be a good thing (she says as we prepare to sweat and snarl our way through the next few months!).

Let's hope everyone facing difficulties manages to get hold of something that enables them to continue functioning well and happily....

Hurdity x

Patent expiration means other pharmaceutical companies will have the same product available soon at lower prices, hence Teva's decision to discontinue FemSeven. When Theramex assumed the Women's Health division, it decided to continue producing FemSeven, but supply issues followed and manufacturing stopped.
Patches leaflet's omissions and errors are subject to the new EU medicine legislation, as well as new safety features on medicine packaging. All these factors have influenced the current shortages.

Of course Brexit has a lot to do with it, as a complicating factor, but specialists in the pharmaceutical field say that Brexit is not the main reason, because shortages were already expected due to a number of issues, as pointed out here: https://www.pharmaceutical-journal.com/opinion/editorial/brexit-is-not-the-only-reason-for-medicines-shortages/20206450.article
 
One more evidence that Brexit is not the main culprit is that HRT drugs are also experiencing shortages in other European countries where FemSeven (other brand names) have become unavailable (Germany, Italy).

Evorel is made by Janssen, Elleste is made by Mylan.

Janssen has already explained that the unavailability of FemSeven was the main reason for an increased demand for Evorel. I have no reason to doubt their explanation. Remember that Janssen is a company headquartered in Belgium but they provide the same product, although with different brand names, to many other countries round the world, they can't just switch products to the UK market to meet the increasing demand, that'll take time (different packages, leaflets, logistics)

Mylan's Elleste raw components come from China that has been experiencing plant closures (mainly due to air pollution) with consequent disruption of supply chains. There are other issues going on at Mylan, but that's beyond this discussion.

BeaR.

[Katejo]

Bear - I'm sure there are behind the scenes politics going on but I can't quite understand the significance of any of the links in relation to current shortages of HRT in UK, especially the last 3. I think I'm missing something here?    I agree I am sure there are complex reasons though!

However I don't buy the argument put about generally in the media (eg BBC) that it's all down to Femseven being temporarily unavailable (although granted there must be some effect) - after all HRT products are being discontinued all the time and women shift to something else. Also it would not explain the shortages of Elleste - this must be something to do with that company Janssen who makes both the products (Evorel and Elleste). We have never seen the like of this before. There surely must be another explanation? At least we know that RCOG and BMS are looking into it but whether we will get the whole picture who knows? Could it be to do with Brexit?

When HRT shortages become number two story on Radio 4 first thing and lunchtime and there are spokespeople from RCOG and BMS then it must be serious! However to look on the positive side - see how much publicity menopause and HRT is getting - that can only be a good thing (she says as we prepare to sweat and snarl our way through the next few months!).

Let's hope everyone facing difficulties manages to get hold of something that enables them to continue functioning well and happily....

Hurdity x

Patent expiration means other pharmaceutical companies will have the same product available soon at lower prices, hence Teva's decision to discontinue FemSeven. When Theramex assumed the Women's Health division, it decided to continue producing FemSeven, but supply issues followed and manufacturing stopped.
Patches leaflet's omissions and errors are subject to the new EU medicine legislation, as well as new safety features on medicine packaging. All these factors have influenced the current shortages.

Of course Brexit has a lot to do with it, as a complicating factor, but specialists in the pharmaceutical field say that Brexit is not the main reason, because shortages were already expected due to a number of issues, as pointed out here: https://www.pharmaceutical-journal.com/opinion/editorial/brexit-is-not-the-only-reason-for-medicines-shortages/20206450.article
 
One more evidence that Brexit is not the main culprit is that HRT drugs are also experiencing shortages in other European countries where FemSeven (other brand names) have become unavailable (Germany, Italy).

Evorel is made by Janssen, Elleste is made by Mylan.

Janssen has already explained that the unavailability of FemSeven was the main reason for an increased demand for Evorel. I have no reason to doubt their explanation. Remember that Janssen is a company headquartered in Belgium but they provide the same product, although with different brand names, to many other countries round the world, they can't just switch products to the UK market to meet the increasing demand, that'll take time (different packages, leaflets, logistics)

Mylan's Elleste raw components come from China that has been experiencing plant closures (mainly due to air pollution) with consequent disruption of supply chains. There are other issues going on at Mylan, but that's beyond this discussion.

BeaR.

I haven't heard anything about HRT being unavailable in other European  countries (except Femseven). I have heard of women here contacting Janssen about the supply problem and being told that they don't have a problem.

[bear]

Hello Katejo,

There are shortages of many drugs worldwide, HRT is just one of them. Two discussion forums, one in Germany https://bfriends.brigitte.de/foren/frauengesundheit/528454-hormonpflaster-nicht-mehr-lieferbar-ich-steh-auf-dem-schlauch.html
another in Italy https://menopausaprecoce.forumfree.it/'t=76171613
The unavailability of Theramex's combi patches will eventually impact on the demand for similar products in all countries where Teva used to sell these products.

Regarding Janssen telling ladies that they don't have a problem, I hope that's true, but why would they submit a press release saying the opposite?



BeaR.

[Hurdity]

Latest update from the BMS:

https://thebms.org.uk/2019/08/british-menopause-society-further-update-on-hrt-supply-shortages/


There are no shortages of Estradot  .

Thanks for the update Saffy. I also note that there has been a joint statement from RCOG, BMS and the Faculty of Sexual and Reproductive Healthcare about all of this:

https://www.rcog.org.uk/en/news/rcog-bms-and-fsrh-position-on-ongoing-hrt-shortages/

Speculation aside, it does sound like the reasons for the shortages are several and complex but whatever the reasons (including commercial) at least we know that these organisations and the professional gynaecologists are doing their best firstly to find out what the issues are and also putting the pressure on the Department of Health and Social Care to attempt to resolve the situation. Let's hope for better news soon!

Hurdity x

[Tc]

This situation has become a debacle.
The pharmasist told me this morning the availability  lists  are already outdated by the time they are circulated. Things are changing daily. He couldnt order estradot 100  on the system so has contacted manufacturer direct but has not received any a week later. Yet on the list they show as available.

[Traceylr]

hi da66
I used the independant pharmacy in the town i was holidaying in. I just took the orignial box the patches came in and asked if they could supply me with them. As I said no hassal at all, they were very helpful. The packaging is the same except the info is in Spanish .Hope you get what you need.
 

[Katejo]

Hello Katejo,

There are shortages of many drugs worldwide, HRT is just one of them. Two discussion forums, one in Germany https://bfriends.brigitte.de/foren/frauengesundheit/528454-hormonpflaster-nicht-mehr-lieferbar-ich-steh-auf-dem-schlauch.html
another in Italy https://menopausaprecoce.forumfree.it/'t=76171613
The unavailability of Theramex's combi patches will eventually impact on the demand for similar products in all countries where Teva used to sell these products.

Regarding Janssen telling ladies that they don't have a problem, I hope that's true, but why would they submit a press release saying the opposite?



BeaR.

  Hello BeaR  I have just had a quick read through a few of the comments in Italian and German. they certainly seem to be having problems. Re Janssen claiming to have stock: I was just referring to a recent discussion on FB in which 1 member was told to ask her pharmacy to contact Janssen directly to order. At that time they did have stock. Maybe they don't now.

[Perinowpost]

Dr Sarah Jarvis on radio 2 just now talking about shortages and the reasons why. She suggested shortages of evorel started it, and that's had a knock on effect on other hrt's as GP's try to find alternatives. She suggested also that it's a knock on effect from the now famous previously flawed studies, as that has resulted in stocks being low as hrt use has actually gone down in this country (due to said flawed studies)! Apologies if this has already been covered.

I'm going to Spain next week and as evorel is one of the ones affected I'm going to try to stock up. Life is too busy to not be able to function x

[Rhiner]

The whole thing is an absolute mess. I cannot manage without Estradot 75ug (no ovaries and after a hormone 'crash' finally settled with this product and took 6 months to get back to normal). The thought of been unable to get this is keeping me awake at night.
I have emailed the MHRA, no response yet. Novartis say that no supply issues, but none appear to be on system at Wholesalers.

Yes, I wish I was going to Spain on holiday to stock up, but Im not (went earlier in year, if hindsight were foresight etc.....).
Rhiner

[Sarald]

I'm feeling very frustrated. I've looked at the list on the BMS website and whilst there are shortages listed it suggests a good number of products are available, specifically ones I have not been able to get hold of for weeks ie, Elleste Solo. So to my mind this list can't be accurate - if there was so much available we wouldn't all be struggling and it wouldn't be so topical in the media.
I've been cold turkey for nearly 3 weeks now and am very distressed, trying Menopace which isn't really doing much. Bad symptoms have really started to kick in again now. I have a GP appointment next week to discuss alternatives and intend to go to the pharmacy first to ask what's available. Already tried this a few times though and the back and forth is difficult ie, the wait for a GP appointment, back & forth to pharmacies, and then some pharmacies not inclined to tell you what they do have in stock.
Really fed up.

[Katejo]

I'm feeling very frustrated. I've looked at the list on the BMS website and whilst there are shortages listed it suggests a good number of products are available, specifically ones I have not been able to get hold of for weeks ie, Elleste Solo. So to my mind this list can't be accurate - if there was so much available we wouldn't all be struggling and it wouldn't be so topical in the media.
I've been cold turkey for nearly 3 weeks now and am very distressed, trying Menopace which isn't really doing much. Bad symptoms have really started to kick in again now. I have a GP appointment next week to discuss alternatives and intend to go to the pharmacy first to ask what's available. Already tried this a few times though and the back and forth is difficult ie, the wait for a GP appointment, back & forth to pharmacies, and then some pharmacies not inclined to tell you what they do have in stock.
Really fed up.

I saw another comment earlier from someone who said that the BMS (and maybe similar sites) are out of date before  we get to see them! The Independent Pharmacy (online) does tell you what is in stock. However Evorel Conti has run out there now too. I have enough to last me until about November/early December but then I am stuck. 

[Saffy]

Estradot are also out of stock at The Independent Pharmacy with this message:

There has been a nationwide shortage with all Estradot products due to a delay in manufacturing.

Currently, the manufacturers are estimating that the item will be available in late 2019.

So, basically, it seems there are no HRT patches available at all?!

[bear]

This may explain the source of the problem regarding FemSeven patches and the domino effect on other brands.

https://www.chemistryworld.com/news/chinese-plant-closures-disrupt-supply-chains/3009954.article

Particularly this:

'Preserving supplies

The Chinese government aims to improve air quality by forcibly closing the country's most polluting
factories, which is having knock-on effects around the world.

The crackdown has already triggered a full-fledged supply crisis.
US trade body the Household & Commercial Products Association (HCPA) has been sounding alarm bells
over a shortage of benzisothiazolinone (BIT), a widely used preservative.
US manufacturers obtain a BIT precursor, o-chloronitrobenzene, almost exclusively
from China. A few months after plants producing the substance have been closed down,
the industry is dealing with ‘complete supply destruction', says Steve Bennett, the
HCPA's senior vice president of scientific affairs.
‘This is a situation that has evolved over the past six to eight months and now we are at
a point where there is virtually no BIT – or formulations containing BIT – remaining in
the supply chain,' he says.
Bennett says formulators are switching to alternatives where possible. But BIT – which
is used in paints, cleaning products, adhesives and other consumer products – is tricky
to replace. It has a fairly long lifetime, high utility and fewer of the skin sensitisation
concerns that keep other preservatives from being used in skin-contact products.
In Europe, the substance is one of few preservatives available to the paints and
detergents industries. Here, too, the responsible trade bodies – the International
Association for Soaps, Detergents and Maintenance Products (Aise) and the European
Council of the Paint, Printing Ink and Artists' Colours Industry (Cepe) – are on edge
over what Aise calls a ‘very fragile supply chain'.

BeaR.

[Yorkshire Girl]

Yes I heard Sarah Jarvis on Radio 2, talking about Everol. I'm on Everol 100mg and have had no problems getting hold of it over the 2.5 years I've been on it! Just lucky I guess.