RCGP Conference: HRT prescribing patterns and financial cost to patients

This month saw the return of the RCGP conference in London and NHMS presented recent findings showing the need for 12 month prescribing for non-complex perimenopausal and menopausal patients.

Founder of NHMS, Dr Louise Newson, supported by Dr Rebecca Lewis and NHMS Director, Lucy Chatwin presented three academic posters at the conference this week, based on recent online surveys to thousands of women.

The benefits of HRT outweigh the risks for most women (NICE guidelines NG23, 2019) and treatment can involve up to 4 different medications. HRT is usually required for several years to bring adequate relief from symptoms and improve wellbeing and quality of life, as well to benefit from the protective effects on future bone and cardiovascular health. It is common prescribing practice to issue medication for 3 months use per prescription and HRT currently has a standard prescription charge in England and there is no prescription charge in Wales and Scotland.

An online survey was created, and questions included asking about whether HRT was on a NHS repeat prescription, the length of time the prescription lasted for, and how much the respondents thought they spent on HRT each year.

From the 1292 responses, over 97% had their HRT supplied by their NHS GP. Although the majority were having their HRT on repeat prescriptions, 20% did not. The length of time of their prescriptions was very variable but the majority was 3 months or less; over half of the respondents (55%) reported that their prescription usually lasted 3 months and less than 10% lasted six months or more.

Regarding financial cost to patients, although 29% of respondents had their prescription costs covered, 59% of respondents reported they spent £51-£150 per year on HRT and 12% estimated they spent £10-£50.

Researchers concluded:

“The perimenopause and menopause is a hormone deficiency and HRT is an effective long term treatment that requires multiple prescriptions, usually for many years. For this reason, it is important that HRT is prescribed on a repeat prescription to minimise unnecessary cost and inconvenience to the patient.

While HRT itself is relatively cheap for the NHS, frequent prescription charges for the patient add up when HRT is prescribed in amounts that last 3 months or less. Whenever it is clinically appropriate, HRT prescriptions should last 6-12 months to reduce the cost to patients to ease access to a cheap, safe and effective treatment for the perimenopause and menopause.”