Some bio-identical hormones are out of stock in pharmacies, victims of the success brought to them by the documentary Lot-Less and the recent decision by the Régie de l’assurance maladie du Québec (RAMQ) to reimburse them.
According to several gynecologists and pharmacists interviewed by The dutypatients treated with estradiol in gel form (marketed under the name Estrogel), a treatment that Quebec has agreed to reimburse since June 2022, have been running out of stock for a few weeks.
However, this hormone must be taken on a regular basis by women taking hormone therapy to alleviate persistent symptoms of menopause or post-menopause, including insomnia, hot flushes or extreme fatigue.
According to several gynecologists, some patients have been told by their pharmacists to “stretch their dose” and wait until supplies return to normal, a situation that might make life very difficult for some patients.
“There are women who will go back to having repeated bleeding, or not sleeping. Telling them to take half a dose doesn’t work. Many are worried, ”says the Dre Diane Francoeur, obstetrician-gynecologist at CHU Sainte-Justine.
An expensive treatment
The shortage of Estrogel also worries the Dre Sophie Desindes, full professor at the University of Sherbrooke and specialist in menopause, who believes that many of her patients will have to forgo treatment with bio-identical hormones, for lack of private insurance.
The shortage, which is said to stem in part from the publicity given to bioidentical hormones by the broadcast of the documentary Lot-Less — which caused the number of prescriptions to jump — and the choice of the RAMQ to reimburse only one bio-identical estrogen in the form of a gel, might have been avoided according to Dre Desindes, since there are other equally effective ones.
“Women who take this gel and who do not have private insurance will have to reduce their doses, because many will not be able to pay. The impact will be a huge detriment to their quality of life, as symptoms can return quickly when treatment is stopped,” she says.
Bio-identical hormone therapy treatments, which are more expensive than traditional hormones, can cost around $80 per month.
An announced shortage
Given the situation, the Dre Desindes strongly urges women affected by the shortage to ask their doctor for a substitute in oral form (covered by RAMQ), if they do not present a risk of thrombosis. Quebec also covers estradiol in the form of transdermal patches, but only as part of an exception drug for patients for whom oral estradiol is contraindicated.
“It’s okay to suffer. Women must turn to a temporary solution. Quebec’s choice to cover only one estradiol gel is really disappointing, because there are other very effective ones,” she points out.
The Quebec Association of Pharmacy Distributors has confirmed that Estrogel has been the subject of a shortage report for several weeks, and there are currently no plans to return to normal before March. Calls made by The duty in several pharmacies have confirmed this situation, with several pharmacists claiming to have already sold out of their stocks of this product.
The multinational company Organon, which produces this gel prescribed to tens of thousands of women in Quebec and Canada, indicated by email Friday that it had notified Health Canada of this situation as early as September, and confirmed that “the available levels do not not meet current demand.
“The generic market is currently experiencing a supply disruption,” adds the company, which says it is actively working to resolve this problem “in the coming weeks. »
“We recognize that this shortage may cause inconvenience to patients, and we remain committed to restoring the supply of Estrogel as quickly as possible. »
