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[Dana]

Well that's just ridiculous. I sent a blasting email to all the email contacts on the Novartis website yesterday. So far it's been acknowledged by one person who told me she had forwarded it on to the "medical information team".

Can I suggest others also send emails or phone as well? If we sit back and say nothing they will just get away with walking all over us. All the contacts are shown here. https://www.novartis.com.au/about-us/contact-us/media-contacts

This goes also for the ladies in other countries/areas with similar problems. You can't just let these pharma companies think that we don't have a voice. You will need to search for your own local contacts though.

[Tempest]

I have a couple of thoughts on this, Dana! As far as I know, they seem to have regular 'production issues' with the Estradot - quite what these are, we can only guess but I think it leaves us all in a very precarious position!

Also, I read over at Hystersisters (US site) that the Vivelle Dot (US name for Estradot) is being replaced by the Minivelle which is produced by Novartis and is about the size of a US quarter, and is round. Women are not liking this as it seems that the round patches seem to 'lift' more than the lozenge shaped dots and are harder to apply as there is difficulty removing the backing as it is removed in one go and then the adhesive has contact with the fingers. I'll pop over and have a further dig around on this. I'm THINKING (and these are just my thoughts) that maybe production is slowing down on the dots to prepare to move to this new product worldwide maybe? Who knows!

It would be nice if us as the consumers were kept informed!

[cubagirl]

That would seem a reasonable explanation Tempest. Like many other products which disappear for months on end, then reappear in new packaging. Never have figured out why there needs to be such long gaps between old & new though. Sounds like bad planning.

[Dana]

Yes "keeping us informed" is exactly the problem I have. I don't have a huge issue with the lack of availability because there are other options, but it's the complete silence and lack of of updates that is really annoying. This is exactly the point I made in my emails yesterday. FWIW here's what I said......

"I'm just wondering when Australian women are going to be given accurate information on when Estradot patches (specifically 50mcg) are going to be available. Pharmacies seem to have no idea, and when they contact their suppliers they either get no call back from them, or aren't given any information anyway. I was initially told they would be available around 24th November, but now there doesn't seem to be any information available at all.

This is seriously not good enough. Women should not be forced to change to different brands or types of delivery, because for a lot of women getting on to the right kind of estrogen supplement can be a very trying and lengthy experience. Menopause is a very stressful and life altering experience for some women and they don't need to have things made worse by not being able to access their medication of choice.

At least make some kind of public announcement, and give us some information. If this is going to go on for much longer women have a right to know, so they can make alternative arrangements. The uncertainty is just not fair, and your silence is insulting. It shows a complete lack of compassion and understanding of their situation."

[Dana]

I've just had an email response from them, and matildamouse your information seems to be correct - unfortunately. It's interesting that apparently a letter has been sent to all pharmacies, but these same pharmacies are saying they have no idea. Who's telling the truth. Anyway here is the email......

Thank you for taking the time to share your concerns and feedback.

Earlier in November we sent the attached letter to all pharmacies and wholesalers, as well as informing both the PBS and TGA.

Unfortunately at this stage we cannot be more specific than the mid-2017 date specified for consistent supply, although there will be intermittent supply before then.

We have taken on-board your feedback and will include a similar statement on the Novartis website to make it easier for both patients and healthcare practitioners to find the information.

Best regards,

Sandoz Pty Ltd

Retail Marketing

54 Waterloo Road

Macquarie Park, NSW 2113

AUSTRALIA

and here is the attached letter that was supposedly sent to the pharmacies at the beginning of November....

10th November 2016

Dear Valued Customer,

Novartis has been a experiencing a disruption in the supply of Estradot, Estalis
Continuous and Estalis Sequi in Australia. We apologise for the inconvenience this has caused
and are working to resolve the fluctuations in supply as a priority. At this time, we anticipate a
return to stable supply in Australia by mid-2017.

Should you have any queries, please find below the contact information.

For all stock queries:
Sandoz Pty Ltd
Customer Service
Telephone: 1800 726 369
Fax: 1800 040 644
Email: [email protected]

For all Adverse Events related to these products:
Novartis Drug Safety
Telephone: 1800 814 677
Fax: 1800 650 493
Email: [email protected]

For all Medical Enquiries, and Product Complaints:
Novartis Medical Information
Telephone: 1800 671 203
Fax: +612 9887 2419
Email: [email protected]

Sincerely,

I'm sorry for the bad news ladies, but at least now you know you will probably have to find an alternative for the time being.

EDIT BY Emma
personal contact details removed by request of Sandos, Australia

[soniad]

Hi Dana,

what do you suggest would be the closest alternative here in Aus?

[Dana]

On the way home just now I called into my local pharmacy and I was happy to see the Senior Pharmacist was on duty because she's always more helpful that the younger ones. I asked her what else is available that isn't likely to go out of stock quickly too and she said that (understandably) when this kind of thing happens it puts pressure on everything else, so there are no guarantees about any of them. However, she printed off the list of HRT from the Australian Menopause Society site, which I already had, and marked the ones that are and aren't available. 

This is a link to the information. http://www.menopause.org.au/for-women/information-sheets/426-ams-guide-to-equivalent-hrt-doses If you scroll about half way down you will see "Oestrogen only therapy" in pink. Then go the "medium dose" section. This is the information she's just given me about 30 minutes ago, but it could change at any time of course.

Available Tablets
Estrofem
Zumenon
Progynova
Premarin

Available Patches
Climara

Available Gel
Sandrena

Estradot and Estraderm are definitely not available.

She agreed that pharmacies have been told that availability will be very dodgy until the middle of next year, so I don't know why other pharmacists don't give out this information too. I told her that I had already ripped into Novartis twice (I sent a reply to the above email I received this morning), and she said "Good" and agreed that it's just not good enough and that they are treating women really badly. She said pharmacists rip into them too, but they don't take any notice of them. She said it will mean more coming from actual customers. I have my doubts about that, but you never know. She also looks about menopause age, so this is probably very close to her heart as well. She may even use Estradot herself.

So I can only say again, make sure you all contact your local Novartis and tell them what you think, even if this shortage hasn't affected you yet, because by the sound of it, it probably will. This sounds like it is a worldwide issue originating in America which is where these things are made.

At this stage I'm not going to worry too much about getting a new prescription for anything. With the combination of all the HRTs I have stashed away (Estradot, Estalis, Progynova and Premarin) I've got about 8-9 months supply on hand. I didn't realise I had so much until I started counting it all up, but now I'm glad I never threw anything out. I just feel really angry for all those ladies who have already struggled so hard to find the right one and don't have a good supply on hand. That's why I've taken to blasting Novartis. I'm also annoyed that my emergency stash is going to be pretty much depleted by the time this is over.

In answer to your question soniad I guess the best alternative initially would be either the Climara patch (which is a once a week patch as opposed to the twice a week Estradot, but my pharmacist said she wasn't aware of any issues with that), or the Sandrena Gel which I've never used so I don't know what it would be like. Of course on-going availability could be the issue.

[Dana]

Just an update. I've decided to get a new prescription from my doctor this afternoon for Climara. I phoned the pharmacy again, just to make sure, and they said it's readily available at the moment, but I'm not taking any chances about what might happen over the next few months. As long as it suits me, I will get a new refill as often as I can, so I'm absolutely sure I have plenty of patches on hand. Who knows, maybe I'll prefer it because you only have to change it once a week.

[soniad]

I've heard Climara can poop out before you get to the 7th day of wearing the patch.

But if it's a choice between that and nothing I'll take it!

I actually managed to get my claws on 2 packets of Estraderm this afternoon. I had no idea they were in short supply as well

[Dana]

Yes I spoke to the Pharmacist on duty this afternoon when I got my new script filled, and he said the delivery was the same, but some people do have an issue with the patch coming off early, or being sensitive to the adhesive because it is a stronger type. They're about 3 times the size of the Estradot, but I don't care about that. No one sees my bum these days..lol...

I'm due to change my patch tomorrow afternoon and even though I've still got a couple of months of Estradot on hand I want to give the Climara a try, and if they are okay I'll get another refill in a few weeks, and keep doing that until I've got a good supply on hand.

You were lucky getting the Estraderm, and two packets!! They will never give me more than one at a time. Did you get a prescription for that, or were you lucky to get a pharmacist who would do a swap? None of them would do that for me. They all said they couldn't substitute and that I would have to get a new prescription.

[Annie0710]

I'm in uk and I think there's been this problem once since I started estradot in summer of 2015.  If it hit here again I'm going to try Tibolone I think.  I had an awful 4 day migraine when I tried a different patch before and that was keeping brand name but going from pill to patch

X

[Rhiner]

Hi All,
Production issues could mean that they have received poor regulatory findings on their manufacturing plant, as they will be inspected by the Regulatory authorities at specific intervals. If this is the case, they will be working with the authorities to put actions in place to sort.  I don't know if Novartis have more than one manufacturing site producing transdermal patches, if they do then it may not effect the other sites.  This may be possible has they have stated 'intermittent supplies'
I do know that in the UK they do not like to sell through the big wholesalers, which want large discounts, and that can be why availability can be difficult here for the big pharmacies.

Rhiner

[soniad]

You were lucky getting the Estraderm, and two packets!! They will never give me more than one at a time. Did you get a prescription for that, or were you lucky to get a pharmacist who would do a swap? None of them would do that for me. They all said they couldn't substitute and that I would have to get a new prescription.

No, none of my pharmacists would do a swap.

I actually got a prescription Dana, but can you believe it - the doctor had never heard of Estraderm and could not find it in her list of available medicines! I had to call the Pharmacist myself while in the Doctor's office and THEY had to explain it to her!

Then she started lecturing me about getting mammograms and the like. Most of these doctors are clueless about the latest HRT treatments and still subscribe to the fear mentality that was generated by the WHI study in 2002.

Thank goodness for this site and all the well-informed helpful ladies on it.

[Dana]

Mammograms aren't a bad thing to have though because with or without HRT you are still susceptible to breast cancer. I get one done privately every year, but you can get free ones every two years. They recommend that all women from 40-75 get one done at least every two years, although younger women are recommended to have ultrasounds as well due to the density of the breast tissue making it harder to see anything.

[soniad]

Yes I agree, just had mine in August this year.