Withdrawal of HT implant may lead to problems for patients

The International Menopause Society is concerned that patients will suffer due to the sudden discontinuation of a HT medication.

MSD, the world's second-largest pharmaceutical company, has decided to discontinue the manufacture of The International Menopause Society is concerned that patients will suffer due to the sudden discontinuation of a HT medication.implants – pellets which are implanted under the skin, and give a continuous flow of the hormone over a period of time. MSD has written to doctors to say that it is no longer economical to manufacture these implants, and that there are alternatives available. However, MSD's decision means that estradiol implants will no longer be available in most countries in the world.

Restricted choices

The International Menopause Society (IMS) is concerned that this will leave many patients with restricted choices on how to continue their treatment. This may mean that it is difficult for a women to settle to a suitable replacement, which in turn could affect her future well-being. 

The IMS is also concerned at MSD's statement that the decision has been taken largely on the grounds of cost-effectiveness, and asks MSD to give greater consideration to the needs of women going through the menopause. In July 2010 MSD announced a process of restructuring which requires the shutting of eight manufacturing plants, and the laying off around 15% of their workforce.

IMS President, Dr Tobie de Villiers (Cape Town, South Africa) said:

"It seems to us that the decision to withdraw the only generally available HT implant will lead to difficulties for many women. MSD says that there are alternative ways to take estradiol, which is true, but that's only half the story.

"Once someone has settled to a particular way to take a medication, any change can be disruptive. Almost all medicines suffer from people not taking them, or forgetting to take them, or getting the dosage wrong, with around half of long-term medicines not being taken properly. Once inserted, an implant allows women to then to effectively forget about it for a few months.

"Now women using implants for the management of menopausal symptoms will have to choose from and acclimatise to different drug-delivery methods. This may cause them difficulties, and some will not adapt well. In fact, many women have decided to use implants because they could not settle to alternative methods. This disruption is not a trivial problem; a drug being available is one thing, but it is of little use if it is not taken."

Dr de Villiers continued: "We have approached MSD to discuss if anything can be done to restart the manufacturing process, but unfortunately, the decision seems to be final." - (Health24, July 2011)

- Press release issued by the International Menopause Society.