Contractor Notice: 6 SSPs for HRT medicines further extended

Update 30/11/22 – The Department of Health and Social Care (DHSC) has provided an update on the Serious Shortage Protocols (SSPs) for 12 HRT SSPs. 6 SSPs were due to expire 30 November 2022 and have been ended. SSPs relating to Sandrena®  0.5mg and 1mg gel sachets have been extended to 13 January 2023.  The table below reflects the SSP expiry dates for the remaining 6 SSPs:

SSP Expiry Date Supporting Information
SSP026 Lenzetto® 1.53mg/dose transdermal spray –  restriction 13 January 2023 SSP026 guide
SSP027 Lenzetto® 1.53mg/dose transdermal spray –  substitution 13 January 2023 SSP027 guide
SSP028 Lenzetto® 1.53mg/dose transdermal spray – substitution and restriction 13 January 2023 SSP028 guide
SSP029 Sandrena®  0.5mg and 1mg gel sachets – restriction 13 January 2023 SSP029 guide
SSP030 Sandrena®  0.5mg and 1mg gel sachets –  substitution 13 January 2023 SSP030 guide
SSP031 Sandrena® 0.5mg and 1mg gel sachets –  substitution and restriction 13 January 2023 SSP031 guide

Update 28/10/22 – The Department of Health and Social Care (DHSC) has provided an update on the Serious Shortage Protocols (SSPs) for 12 HRT SSPs. All 12 SSPs were due to expire 28 October 2022 but have been further extended.  The table below reflects the new SSP expiry dates for all 12 SSPs:

SSP Expiry Date Supporting Information
SSP019 Oestrogel® Pump-Pack 0.06% gel – restriction 30 November 2022 SSP019 guide
SSP020 Ovestin® 1mg cream – restriction 30 November 2022 SSP020 guide
SSP022 Oestrogel® Pump-Pack 0.06% gel (750microgram per actuation) – substitution 30 November 2022 SSP022 guide
SSP023 Oestrogel® Pump-Pack 0.06% gel (750microgram per actuation) – substitution and restriction 30 November 2022 SSP023 guide
SSP024 Ovestin® 1mg cream – substitution 30 November 2022 SSP024 guide
SSP025 Ovestin® 1mg cream – substitution and restriction 30 November 2022 SSP025 guide
SSP026 Lenzetto® 1.53mg/dose transdermal spray –  restriction 13 January 2023 SSP026 guide
SSP027 Lenzetto® 1.53mg/dose transdermal spray –  substitution 13 January 2023 SSP027 guide
SSP028 Lenzetto® 1.53mg/dose transdermal spray – substitution and restriction 13 January 2023 SSP028 guide
SSP029 Sandrena®  0.5mg and 1mg gel sachets – restriction 30 November 2022 SSP029 guide
SSP030 Sandrena®  0.5mg and 1mg gel sachets –  substitution 30 November 2022 SSP030 guide
SSP031 Sandrena® 0.5mg and 1mg gel sachets –  substitution and restriction 30 November 2022 SSP031 guide

Twelve of the thirteen Hormone Replacement Therapy (HRT) Serious Shortage Protocols (SSPs) have been extended to 28 October 2022. This is to help manage the ongoing supply disruptions affecting the availability of certain HRT medicines. The HRT SSPs which have been extended include SSP019, SSP020 and SSPs 022 – 031 (see table below).

In addition, the dose equivalence advice and endorsement guidance for SSP024 and SSP025 was updated.  SSP024 and SSP025 was updated by DHSC to provide greater clarity to pharmacists on the dose equivalences to determine the appropriate quantity to supply.  Please refer to the latest SSP versions and endorsement guidance published on NHSBSA’s website.

The table below shows all HRT SSPs with an extended expiry date.

Drug name SSP
Restriction of the quantity supplied (for prescriptions ordering > 3 months) Substitution with a specific alternative product (for prescriptions ordering < 3 months) Substitution with a specific alternative product AND restriction of the quantity supplied (for prescriptions ordering > 3 months)
Ovestin® 1mg cream SSP 020 SSP 024 (update to dose equivalence advice and endorsing guide – see latest versions) SSP 025 (update to dose equivalence advice and endorsing guide – see latest versions)
Oestrogel® Pump-Pack 0.06% gel SSP 019 SSP 022 SSP 023
Lenzetto® 1.53mg/dose transdermal spray SSP 026 SSP 027 SSP 028
Sandrena® 0.5mg and 1mg gel sachets SSP 029 SSP 030 SSP 031

Pharmacists are required to read and comply with the requirements outlined within the individual SSPs and supporting guidance as published on the NHSBSA website for the HRT products listed above.

HRT SSPs

For four HRT medicines affected by ongoing supply disruptions, a total of 12 individual SSPs remain valid for use which allow either:

  • Restriction of the quantity supplied – where a prescription has a duration of more than three months and supplies are available, an equivalent of three months’ supply will be permitted in accordance with the SSP for the prescribed medicine; or
  • Substitution with a specific alternative product – where the prescribed duration of treatment is three months or less and supplies are unavailable, a pharmacist can supply a specific alternative product sufficient to provide a reasonable estimate of the prescribed duration of treatment, if deemed clinically appropriate; or
  • Substitution with a specific alternative product AND restriction of the quantity supplied – where a prescription has a duration of more than three months and supplies are unavailable, the SSPs will allow pharmacists to provide three months’ supply of specific alternative product.

Additional Resources

Endorsement guidance and FAQs for HRT SSPs now live – update

Serious Shortage Protocols (SSPs) – PSNC website

Serious shortage protocols (SSPs) – NHSBSA website

PSNC Briefing 011/21: Serious Shortage Protocols (SSPs) updated endorsing guidance

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