Pfizer Canada is ending sales of Premarin vaginal cream after a shortage since June, with tablet supplies expected to last until about mid-2027.
Pfizer Canada is discontinuing the sale of Premarin vaginal cream in Canada following an internal review, the company announced on Thursday. The cream has been in shortage in Canada since June, and no further batches will be supplied.
Pfizer confirmed to Reuters that it will stop selling Premarin vaginal cream and all three strengths of Premarin oral tablets in Canada. Existing inventories of the tablets in 0.3 mg, 0.625 mg and 1.25 mg strengths are expected to last until about mid-2027, though stocks could run out sooner if demand increases. Premarin Intravenous, used in hospitals to treat abnormal uterine bleeding caused by hormonal imbalance, is not affected.
Pfizer said the decision was not related to any new safety, efficacy or quality concerns, and that other treatment options were available in Canada.
The Canadian Pharmacists Association published a list of alternatives amid the menopausal hormone therapy shortage. In Ontario, the one other vaginal cream available is not covered by the Ontario Drug Program, a program covering the costs of more than 5,900 medications.
A spokesperson for the Ontario Ministry of Health said among the vaginal estrogen products listed by the Canadian Menopause Society as alternatives, there are three covered under ODP: Estring (vaginal ring), Vagifem 10 (vaginal tablet), and Imvexxy (vaginal inserts). In Ontario, the extended-release tablets are covered by the Exceptional Access Program, meaning coverage is only offered if specific clinical circumstances are met.
Health Canada’s drug shortage database lists an active shortage of Premarin vaginal cream, 0.625 mg in a 30 g tube, filed by Pfizer Canada ULC on June 22 and last updated on August 18. The reported reason is disruption of the manufacture of the drug. The product, drug identification number 02043440, has drawn repeated shortage reports since 2017.
Other hormone therapy products are also facing supply constraints in Canada, including estradiol transdermal patches made by Bayer and Sandoz. Health Canada said earlier this month that intermittent shortages are expected to last until early next year, adding that patients may find certain strengths of the product are temporarily unavailable at their local pharmacy.
Dr. Amanda Selk, an obstetrician-gynecologist at Mount Sinai Hospital, said the vaginal cream is generally used for menopausal women to restore moisture and estrogen, and that some data suggests it can help with bladder infections as well. She said patients lose choices when a product is discontinued.
"Different drugs work well for different people, so some might prefer what’s there now, and some people might prefer what was there before, and so we lost choices," Selk said in an interview with CTV News Toronto.
She said women are frustrated and that the supply chain has not been able to keep up with demand for estrogen products, reflecting what she described as a more general problem regarding women’s health.
Sources
This article was drafted with AI assistance and checked against the sources above. Company claims are reported as claims. Cover image is AI-generated.
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