The latest shortage is progesterone, and it landed this week
As of today, perimenopausal and menopausal women across New Zealand are being rationed progesterone capsules because demand has outstripped supply. Pharmac confirmed that people “might receive smaller supplies than usual to ensure everyone can continue to access this important treatment.” One woman received just eight tablets from her pharmacist, enough for a few days, with her full script unfulfilled.
This is not a one-off. It is the latest failure in a procurement model that has been breaking down for years, and the costs are being silently absorbed by employers who have no idea their workforce productivity is being eroded by a government agency’s purchasing decisions.
A pattern running since 2020
Pharmac became aware of constrained oestradiol patch supply as early as May 2020. Demand had been surging, with annual patch dispensing growing 39% year on year between July 2018 and June 2023, reaching 4.04 million patches in 2023/24, a 218% increase from 1.27 million in 2020/21.
By mid-2024, the shortage was acute. A survey found 70% of respondents had been told by pharmacists they had no patches available, 8% had visited five or more pharmacies, and 13% could not get medication at all. One pharmacy had a waiting list of 80 people.
The root cause was structural. In December 2024, University of Auckland health professionals argued in Newsroom that Pharmac funded only a single patch brand, Mylan, used by just a quarter of oestradiol users. When that sole source came under pressure, the entire supply base collapsed.
The workforce damage employers are not measuring
Here is where the business case sharpens. Workplace consultant Kate Billing wrote in July 2024 that over 500,000 women in the peri/menopause life stage are in paid employment in New Zealand. She asked employers directly: “Do you know how many women are being impacted by this shortage in your organisation?”
The answer, overwhelmingly, is no. But the data exists.
Dr Samantha Newman’s survey of over 2,300 HRT users, published in August 2024, found a third of respondents said shortages had affected their ability to perform in their job. Twenty percent had taken time off work. Among teachers and nurses specifically, 20% in each profession had skipped work. Newman noted the sectoral concentration: “That’s a huge issue for our country when our hospitals, medical facilities and schools are stretched.”
A separate RNZ survey of over 2,000 users in June 2024 found 80% had their mental health affected and 70% reported physical health suffering.
The hidden subsidy employers are paying
Women who can afford alternatives are paying $92 to $200 per month out of pocket for unfunded alternatives. Over half of survey respondents had paid privately during shortages. Those who cannot afford it simply go without, and the productivity loss flows directly to employers as absenteeism, presenteeism, and attrition.
The Auckland academics framed it plainly: “Supporting women’s health is not just a healthcare matter – it is an economic imperative. Optimising women’s health in midlife is critical to the workforce and economy.”
Pharmac’s model externalises cost onto businesses
Pharmac manages around 20 to 30 supply issues at any one time across the system. Its 2024-25 annual report documents leadership turnover, a board-commissioned culture review, and a five-year change programme commencing July 2025. The government has committed $604 million over four years for medicine funding.
But the fundamental problem remains: a procurement model built around single-supplier contracts and reactive demand management. When that model fails, the costs do not appear on Pharmac’s balance sheet. They appear in your team’s sick leave register, in the experienced nurse who quietly resigns, in the senior manager whose output drops for months without explanation.
Businesses planning workforce strategy, retention budgets, and wellbeing programmes need to understand that a meaningful slice of their unexplained productivity loss traces back to a government agency that buys medicine the same way it buys paperclips: one supplier, lowest price, hope for the best.
Sources
- Menopause medication rationed as demand outstrips supply (2026-04-29)
- Women forced to shop around five or more pharmacies to get hormone patches (2024-06-17)
- Pharmac must fund more options for hormone therapy, not fewer (2024-12-04)
- NZ’s HRT Shortage and Our Workplaces (2024-07-04)
- Mental Health Declines, Relationships And Jobs At Risk Without HRT, Survey Results Show (2024-08-07)
- NZ women on a mental precipice as a result of HRT shortage – survey (2024-06-17)
- Shortage of oestradiol transdermal products – Pharmac OIA (2024-06-18)
- Request for Proposals – Supply of oestradiol gel (2024-05-13)
- Supply issue data – Pharmac (2025-05-30)
- Pharmac Annual Report 2024-25 (2025-10-31)