In recent weeks patients in the UK found it harder to find letrozole, a medication used in the treatment of some breast cancers. Letrozole shortage affected most pharmaceutical wholesalers, but not all. However, with the rising prices of letrozole, patients may still find it difficult to obtain it, despite its availability.
What is letrozole?
Letrozole is a medication that belongs to a class of drugs called aromatase inhibitors. It is primarily used in the treatment of hormone receptor-positive breast cancer in postmenopausal women. Hormone receptor-positive breast cancer relies on the hormone estrogen to grow and spread. Letrozole works by inhibiting the enzyme aromatase, which is responsible for converting androgens (male hormones) into estrogen. By reducing the production of estrogen, letrozole helps to slow down or stop the growth of hormone receptor-positive breast cancer cells.
Letrozole shortage – can you still find letrozole?
Most pharmacies in the UK use 3-4 pharmaceutical wholesalers. In recent weeks, letrozole has been out of stock in the main wholesalers:
- Alliance Healthcare (owns Boots Pharmacy), which also supplies other pharmacies
- AHH Pharmaceuticals (Lloyds Pharmacy), which also supplies other pharmacies in the UK
- Sigma Pharmaceuticals, which supplies mainly independent pharmacies
During the same time and until now, letrozole has been available and supplied without major shortages by Pheonix.
Pheonix owns Rowlands Pharmacy, a chain of over 527 pharmacies in the UK and Numark Pharmacy, a pharmacy membership organisation in the U.K. with over 3300 members. Pheonix is therefore the main supplier for Rowlands Pharmacy and Numark Pharmacies (independent pharmacies).
How to get letrozole during the letrozole shortage?
Choosing a pharmacy which uses Pheonix as the main pharmaceutical wholesalers increase the chances of getting letrozole. Patients should try to get it either from Rowlands Pharmacy, Numark Pharmacy or any other independent pharmacy which uses Pheonix.
One may ask why letrozole is not available widely, for example in Boots Pharmacies?
Many pharmacies in the UK usually choose one main supplier who provides a majority of their drugs. Boots Pharmacy does not use Pheonix as a pharmaceutical supplier, which explains the letrozole shortage in Boots Pharmacies. Additionally, when one pharmacy has a selected main supplier, it may not be able to order common drugs from other suppliers due to various restrictions.
Letrozole shortage – rise in price
When a drug is short in supply, pharmaceutical wholesalers usually increase the price of a drug. Since letrozole is currently only available in Pheonix, the price for letrozole was increased by this supplier, usually above the reimbursement price set by NHS. Consequently, a pharmacy which supplies the drug and makes a loss.
Supply of medicines at a loss is a common practice which put huge financial strain on pharmacies in the UK. Recently, one of the most commonly prescribed medications for the treatment of high cholesterol, atorvastatin has been affected by the same problematic scenario. The apparent shortage of atorvastatin led to an increase in the price of this essential drug by 400%.
As result pharmacies may decide not to supply the drug to patients despite its availability. The outdated reimbursement system for the supply of drugs by pharmacies is slow and does not make changes in the prices of drugs accurately. Unfortunately, wholesalers take advantage of the system and change the prices almost as they wish, with no intervention from the Government. This is one of the factors which contribute to the closure of pharmacies in the UK.
Can you transfer the prescription for letrozole from one to another pharmacy?
It is possible to transfer a prescription from one to another pharmacy, providing no other items on the prescription were dispensed. Patients who wish their prescription to be transferred to another pharmacy need to ask the holding pharmacy to return the prescription to ‘spine’. Once this is done, the prescription can be downloaded by any pharmacy.
What are letrozole alternative drugs?
Letrozole is a medication primarily used to treat breast cancer in postmenopausal women. It belongs to a class of drugs called aromatase inhibitors, which work by reducing the production of estrogen in the body.
If letrozole is not suitable or not available for a particular individual, there are alternative drugs that may be considered. It’s important to note that the specific choice of alternative will depend on the individual’s medical condition and preferences. Main letrozole alternative drugs:
- Anastrozole: Anastrozole is another aromatase inhibitor commonly used in the treatment of breast cancer. It works similarly to letrozole by reducing estrogen levels.
- Exemestane: Exemestane is another aromatase inhibitor that is used to treat breast cancer. It works by permanently inactivating aromatase enzymes, thus reducing estrogen production.
- Tamoxifen: Tamoxifen is a selective estrogen receptor modulator (SERM) that is often used in the treatment of breast cancer. It works by blocking the effects of estrogen on breast tissue.
