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Women in the US struggling to find hormone replacement treatments to manage menopause \u200bsymptoms are facing shortages beyond estrogen patches amid surging demand, with some injectable and vaginal estrogen products also in short supply. Cost Plus Drugs, the online pharmacy founded by billionaire entrepreneur Mark Cuban, \u200csaid it \u2060was buying as much as possible from suppliers to maintain inventory levels.<\/strong><\/p>\n Cuban said demand for products sold through the platform had surged fivefold to tenfold \u201cfor almost every product\u201d because of its low prices, while its suppliers were expanding capacity.<\/p>\n Cost Plus Drugs has been able to maintain estrogen replacement supplies with only intermittent interruptions, Cuban said in an email.<\/p>\n The \u200cUS Food and Drug Administration has been working with manufacturers since September to boost supplies of estrogen patches after months of shortages. But pharmacies and drug-shortage monitors are reporting problems with other forms of the hormone.<\/p>\n Demand for hormone replacement therapy has increased following the FDA\u2019s removal last year of a long-standing boxed warning on some hormone therapy that had signalled possible \u200bheightened risk of breast and ovarian cancer, as well as strokes and other serious conditions found in a large 2002 study.<\/p>\n The new shortages \u200bmay partly reflect women switching from patches that have become harder to find to alternative hormone therapy products, said Kevin \u2060Schipper, director of product lifecycle management at pharmaceutical consulting firm ProPharma.<\/p>\n The American Society of Health-System Pharmacists early in September listed multiple estradiol injection products from \u200bHikma, American Regent and Par Sterile Products as being in shortage.<\/p>\n Separately, ASHP lists vaginal estradiol creams made by Viatris\u2019 Mylan unit, Padagis, and Teva as being \u200bon backorder or allocation.<\/p>\n The FDA did not respond to a request for comment on the latest shortages.<\/p>\n CVS Health said manufacturers have struggled over the past several months to provide sufficient supplies of certain strengths of estradiol injections, a situation it said has worsened in recent weeks.<\/p>\n Dr. Kathleen Jordan, chief medical officer of telehealth provider Midi Health, described \u200ba growing number of supply-chain issues.<\/p>\n \u201cPersistent patch shortages have been going on for a while and as prescribers and their patients go to alternative gels \u200band creams, there has been a domino effect impacting the supplies of these prescriptions as well,\u201d she said.<\/p>\n The FDA said in September that the US supply of FDA-approved estradiol patches had nearly doubled over the \u200bprevious year but had not kept up \u200bwith demand.<\/p>\n Viatris, one of several \u2060manufacturers of estradiol patches and creams, said it had seen a \u201csignificant surge in demand\u201d and had been working throughout the year to increase supply. The company added a production shift at its<\/p>\n St. Albans, Vermont, facility earlier this year, \u200btaking the plant to around-the-clock production, and said its output was now significantly higher.<\/p>\n \u201cWe are meeting our current \u200bsupply plans for estradiol \u2060vaginal cream and are committed to supporting patient access to this needed treatment,\u201d Viatris said.<\/p>\n The company added that it was investing in additional equipment and adding a new production line to expand long-term capacity. It is also pursuing potential partnerships with third parties to further increase the patch supply.<\/p>\n Amneal, another manufacturer of estradiol patches, \u2060said demand \u200bhad increased significantly following the FDA\u2019s warning removal and that it was working to increase \u200bproduction.<\/p>\n Teva, Padagis, Hikma, American Regent and Par Health did not respond to Reuters requests for comment.<\/p>\n ProPharma\u2019s Schipper said the pattern of shortages did not appear to point to a broad lack of \u200braw materials, although he cautioned that supply-chain problems could still be contributing to disruptions.<\/p>\n<\/div>\nHIGH DEMAND<\/strong><\/h3>\n