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Estradot shortage sparks hormonal havoc

In brief
  • The shortage of hormone replacement therapy medication is causing anxiety and frustration among patients.
  • Pharmac is being encouraged to establish more supply lines.
  • New Zealand ranks last among 20 comparable countries for medication access.


A shortage of Estradot, a brand of hormone replacement therapy (HRT) medication, is causing significant anxiety and frustration among numerous Kiwis who depend on it daily. The drug is widely used to treat women experiencing symptoms of menopause. 

The shortage is attributed to increased demand, which began in 2020 and has since worsened. Patients have been forced to use alternative brands and there is a concern about negative side effects.

Doctors and patients are urging Pharmac to fund additional estrogen options, such as gels, and to provide more patches per week to each patient. They also want to extend prescription durations to accommodate Estradot delays.

Pharmac has stated there “is significant stock in the supply chain”, but the situation remains deeply frustrating for thousands of affected individuals.

Estradot shortage sparks hormonal havoc - Centrist
Is Pharmac cutting it when it comes to supplying Kiwis with critical medications?

Nothing new

Shortages of prescription drugs is not new in New Zealand. In the past the problem has sometimes been attributed to the tendering process of Pharmac. The process, focused on minimizing costs, has led to some drug companies withdrawing from the market and reducing their stock levels. 

There have been increasing calls over the years for a comprehensive review of Pharmac’s sole supply agreements with drug manufacturers in response to the ongoing issue of medication shortages in New Zealand. 

A 2020 report, by Medicines New Zealand, revealed New Zealand ranks last among 20 comparable OECD countries for access to modern medicines. 

It highlighted the significant lag in the time it takes to publicly fund essential medications, with an average of 659 days compared to an average of 273 days in other countries. The report emphasized that delays in accessing essential medications can have potentially fatal consequences.

At the time, Medicines New Zealand Chairwoman Dr. Lee Mathias expressed concern over New Zealand’s decision to prioritize cost savings over patient well-being, something becoming more common in public health.

By relying on single manufacturers for each medication, NZ becomes more vulnerable to disruptions in supply, as seen with the shortages of critical drugs like  antidepressants, contraceptives, and paracetamol during the COVID-19 pandemic.

Does the process need tweaking?

Pharmac defended its approach at the time, insisting the sole supply agreements do have benefits. According to Pharmac CEO Sarah Fitt, suppliers are often responsible for the cost of alternative drugs when shortages occur, putting pressure on them to find suitable substitutes. 

Pharmac modified its tender process in late 2020, but the need for a review of Pharmac’s supply agreements persists. Patient advocacy groups and industry professionals are still highlighting supply issues that the current model fails to adequately address. 

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