Chart of the week: Hormone replacement therapy prescriptions rise 42% in one year

Each week we present analysis of data in chart form to illustrate some key issues and invite discussion. Shortages of hormone replacement therapy products have been in the news recently, and the number of prescription items in England related to HRT have doubled over the last seven years. John Appleby shows how a large part of this increase was during 2021/22.

Data story

Published: 23/06/2022

Shortages of some hormone replacement therapy (HRT) products have hit the headlines lately. Some manufacturers report running out of supplies, with pharmacies having to make local rationing decisions to try and ensure women do not run out of treatments.

The problems with supply have largely been due to manufacturers not responding quickly enough to recent changes in demand. Over the last seven years, the number of prescription items in England related to HRT have doubled. But as our chart of the week shows, a large part of this increase was in the financial year 2021/22, with a 42% rise over the previous year. Costs have also doubled, from £36.5 million to £77.3 million a year.

The increase in 2021/22 is probably a combination of a catch up following difficulties in accessing health services during the pandemic, and a response by GPs to patient groups – including notably the broadcaster Davina McCall – who have been campaigning about the benefits of HRT and changes in prescription charges.

On charges, the government announced that from April next year the cost of prescriptions for HRT products will be cut with the introduction of an annual prescription prepayment certificate. This will allow access to an annual supply of HRT therapies for the cost of two prescription items at £18.70.  

The government has also appointed an ‘HRT Tsar’ – the head of the Vaccines Taskforce, Madelaine McTernan – to improve the supply of HRT products. Interestingly, pharmacists have now been given a temporary power to substitute some short-supply prescribed items to better meet demand. This should help ease the current problem. Whether this power might be made permanent, and perhaps extended to other areas of prescribing as the Royal Pharmaceutical Society has argued, remains to be seen.   

HRT prescriptions rise 42% in one year 23/06/2022



Calendar years used to 2019 and financial years from 2020/21 as consistent data not available.


Nuffield Trust analysis of NHS Business Services Authority, Prescription Cost Analysis (England) data.

Read more