New NHS Business Services Authority (NHS BSA) data has revealed that the number of HRT medication items prescribed in England hit 13.3 million in 2023/24 – up 21.5% from the 10.9m prescribed in 2022/23.
The report published earlier this month (October 17) showed that this is an increase of over 10 million since 2015/16, when the number stood at 3.1 million items.
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It found that Utrogestan 100mg capsules were most frequently prescribed in 2023/24 with 1.33 million items, an increase of 41.7% from 935,000 the previous year.
It comes after a new HRT prescription pre-payment certificate (PPC) was introduced in April last year to cover medication licensed to treat the menopause in the UK, which currently costs patients £19.80 per year.
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The NHS BSA report is limited to the medication covered by the HRT PPC and said that in 2023/24, the proportion of HRT items for which an HRT PPC was used stood at 14.5%.
In the first financial quarter of 2024/25 covering April to June 2024, the proportion of items where an HRT PPC was used increased to 20.7%, it added.
HRT inequality
Meanwhile, the report also revealed that women in England’s most deprived areas are half as likely to access HRT - a pattern that “has been consistent since 2015/16”.
The data showed that 739,597 identified patients in the “least deprived” areas were prescribed HRT in 2023/24 compared to 324,630 in the “most deprived” areas.
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Four of the five integrated care boards (ICBs) with the lowest number of patients to receive at least one HRT item were in London, with NHS North East London ICB the lowest at around 19 patients per 1,000, it found.
And it revealed that the five ICBs with the highest numbers of patients prescribed HRT were all located in the south of England and had over sixty patients per 1,000 receiving at least one HRT item, with NHS Cornwall and the Isles of Scilly ICB recording the highest number at 68.
Inequalities “unacceptable”
NHS national clinical director for women’s health Dr Sue Mann said that the rise in items “reflects the sharp increase in menopause awareness in recent years”.
But she added that “there is more work to do to increase awareness and reduce inequalities in access”.
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Pharmacist and lawyer Thorrun Govind said that it “doesn’t surprise” her that there is still “this large difference” between those in the most and least deprived areas as “there is a cultural element to women’s health” because “there are still some communities where we still need to have a better conversation about women’s health”.
And National Association of Women Pharmacists (NAWP) president Lourette Philips told C+D that while she was “glad to see there is an increase in prescribing for HRT”, the inequalities in access are “disappointing and unacceptable”.
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“The findings show that the most deprived areas may not get the same access to healthcare or there is a lack of awareness about menopause and available treatment,” she said.
“They might not know the language to explain their symptoms so they can access treatment,” she added.
Community Pharmacy England (CPE) chief executive Janet Morrison added that “commissioning pharmacies to provide menopause advice – including the supply of HRT through independent prescribing – …is a priority for CPE’s service development”.
