The estradiol patch shortage seems to be worsening nationally. The FDA has yet to acknowledge this medication shortage. We understand that it is having a significant impact. Below are steps that you can take as well as some alternative medications we can switch you to if needed.
Find Your Patch At Another Pharmacy
Unfortunately, it is incumbent upon you to call around and check on availability. Most patients have been successful in finding their patch at an alternative pharmacy, but it sometimes takes some legwork. There is no database we can check. Be sure to check your pharmacy benefits with your insurance first so you know which pharmacies you can switch to.
When finding the medication, keep in mind this is an ever-changing situation. One pharmacy might have your patch on one day and not the next. All pharmacies’ supply fluctuates, including national mail-order pharmacies; make sure you confirm stock with mail-order pharmacies as well. Express Scripts has been sending letters to patient asking them to transfer their estradiol patch prescription to them and get a 90-day supply, when they don’t even have the patch you need in stock. Be wary of these types of requests unless you have confirmed that they have your patch in stock.
Consider alternative mail-order pharmacies like Mark Cuban Cost-Plus Drugs, Amazon Pharmacy, and HRT Club. For these, you must have an established account, and some require a subscription. Please review any associated fees and whether they accept insurance.
Possible Alternatives
Find an alternative estradiol patch. Find a higher-dose patch that you can cut to an approximate size/dose of your current patch. For example, a 0.075 mg patch can be altered to a 0.05 mg patch by cutting off 1/3, or a 0.1 mg patch can be cut in half. Make sure to confirm with the pharmacy that they have the higher dose patch in stock AND that it is a matrix patch that can be cut. Not all patches can be cut, and not all pharmacists will be willing to dispense this type of prescription, so be sure to confirm first. You can also switch your twice-weekly patch to a once-weekly patch, though these patches are larger and can cause more skin irritation since they are in the same location for seven days. Again, confirm that the pharmacy has this option in stock first.
Estradiol gel is another alternative to the patch; it is applied once a day, and a 1.0 mg gel packet daily is equivalent to using a 0.05 mg patch twice weekly. Not all insurance companies will pay for the gel, but there are some GoodRx coupons to decrease the cost.
Some women can switch to oral estradiol or oral conjugated equine estrogen. Because oral estrogen is metabolized by the liver, it has a different side effect profile. Oral estrogen actually has a stronger favorable effect on the cholesterol profile than transdermal estradiol. However, it is not an ideal choice for those at higher risk of blood clots and stroke, such as women with a history of migraine with aura, women with high blood pressure, diabetes, or nicotine users. It can also increase your risk of gallbladder disease. Oral estradiol has the advantage of being very inexpensive.
You can also consider switching to Duavee, which is oral conjugated equine estrogen plus a SERM (selective estrogen receptor modulator) in place of a progestogen. SERMS are anti-estrogen in the breast and endometrial lining of the uterus while being pro-estrogen in the bones. The cost with a GoodRx coupon is about $30 per month. This is a good substitute if you were on a 0.05 mg patch or lower.
You can check your health plan and see if the Femring is covered. The Femring is inserted in the vagina and releases systemic levels of estradiol over a three-month period.
Communicate With Our Team
If you found your patch at another pharmacy and need to get it transferred, you can reach out to our nurse Ashley, who can process prescription transfers. You can message Ashley in the patient portal or reach out via call/text at (505) 705 1109. Please include the details of the pharmacy you want to transfer to. Your old prescription will be canceled, and a new prescription will be sent. Ashley cannot make changes to any prescriptions; if you need a change, Jane will process the request.
If you want to switch to an alternative medication, send Jane a message through the portal with the medication you would like to be switched to. Remember that some alternatives might not be the best fit for you, so there may be some back-and-forth in the portal. Please be prompt with your replies so Jane can get you the best option as fast as possible. If you have questions or concerns, please book a follow-up to touch base.
