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HRT (menopause)

Estradiol prescribing across the NHS.

Estradiol is the engine of the HRT revival: 8.6m items and £128m at list price in the year to April 2026, spanning gels, patches, sprays and vaginal preparations in one line. Prescribing rises steeply with affluence; the gradient across England's deprivation deciles is among the starkest for any major molecule on this site.

Scorecard, last 12 months
Items
8.9m
dispensed in the last 12 months
Spend
£134.8m
at NIC, last 12 months
Year on year
+14.8% +14.8%
vs the 12 months before
Latest month
July 2026
most recent NHSBSA release
Key facts · plain English

The NHS in England dispensed 8,916,608 prescription items of Estradiol in the 12 months to July 2026, across primary care and hospitals.

Spending on Estradiol over those 12 months was £134.8m at net ingredient cost, the list price of what was dispensed before any discounts.

Items were up 14.8% on the previous 12 months.

99% of Estradiol volume moved through primary care and 1% through hospital pharmacies.

Estradiol is the largest of 8 chemical substances in Oestrogens and Hormone Replacement Therapy (BNF 6.4.1.1), by items dispensed.

Among Integrated Care Boards, NHS Surrey and Sussex ICB dispensed the highest volume of Estradiol.

Source: NHS Business Services Authority open data (English Prescribing Data and SCMD), OGL v3.0. Items count prescriptions dispensed, not patients treated.

National trend · since 2020
Estradiol, England: monthly items and spend
Items per month (teal) and spend, £ (orange)
items £ 2020-11 2023-09 2026-07 3 Jul 2026 · Parallel import licence granted12 Jun 2026 · Parallel import licence granted1 Jun 2026 · Price concession granted1 May 2026 · Price concession granted1 Apr 2026 · Price concession granted6 Mar 2026 · Parallel import licence granted1 Mar 2026 · Price concession granted6 Feb 2026 · Parallel import licence granted1 Feb 2026 · Price concession granted7 Jan 2026 · Parallel import licence granted1 Jan 2026 · Price concession granted1 Dec 2025 · Price concession granted1 Nov 2025 · Price concession granted1 Oct 2025 · Price concession granted1 May 2025 · Hospital framework awarded1 May 2025 · Price concession granted3 Apr 2025 · Supply shortage1 Apr 2025 · Price concession granted1 Mar 2025 · Price concession granted1 Feb 2025 · Hospital framework awarded1 Feb 2025 · Price concession granted1 Jan 2025 · Price concession granted19 Dec 2024 · Supply shortage12 Sep 2024 · MHRA safety alert1 Jun 2024 · Hospital framework awarded19 Mar 2024 · MHRA safety alert8 Dec 2023 · Shortage resolved21 Aug 2023 · Supply shortage5 May 2023 · Shortage resolved13 Apr 2023 · Supply shortage17 Feb 2023 · Shortage resolved25 Jan 2023 · Supply shortage13 Jan 2023 · Shortage resolved15 Nov 2022 · Supply shortage16 Sep 2022 · Shortage resolved8 Sep 2022 · Supply shortage19 Aug 2022 · Shortage resolved19 May 2022 · Supply shortage
Source: NHSBSA English Prescribing Data (OGL v3.0).

Diamond markers show events around this period: NICE decisions, safety alerts, supply notices, Drug Tariff moves and price concessions, new suppliers in dm+d and framework awards. Hover a marker for the date and type. The evidence behind each one, with the source quote and link, sits behind Apply.

MonthItemsSpend (NIC)
July 2026 845,626 £12.8m
June 2026 795,012 £12.1m
May 2026 756,947 £11.5m
April 2026 756,027 £11.5m
March 2026 768,694 £11.7m
February 2026 691,048 £10.5m
January 2026 742,815 £11.2m
December 2025 754,713 £11.4m
November 2025 695,634 £10.5m
October 2025 736,898 £11.2m
September 2025 707,509 £10.5m
August 2025 665,685 £9.8m

The same series as the chart, most recent month first. The full monthly history, as CSV, sits behind Apply.

Cost per item · price erosion
Estradiol, England: cost per item
Actual cost per item, primary care (£)
£15.68 £10.69 2020-11 2023-09 2026-07
Source: NHSBSA English Prescribing Data (OGL v3.0).
Market share

71.9% of its class.

Estradiol is the largest of 8 chemical substances in Oestrogens and Hormone Replacement Therapy (BNF 6.4.1.1), by items dispensed in July 2026. The full class league, who's gaining, and the month-by-month share movement sit behind Apply.

See the full class picture →

Seasonality
Average items by calendar month, indexed to the year (100 = average)
120 100 80 JFMAMJJASOND

Average items by calendar month across the full history, indexed to the annual mean.

Who supplies it · dm+d register

24 suppliers hold a live estradiol listing, across 87 packs.

A A H Pharmaceuticals Ltd, Accord-UK Ltd, Advanz Pharma, Alliance Healthcare (Distribution) Ltd, Bayer Plc, Besins Healthcare (UK) Ltd, CST Pharma Ltd, Exeltis UK Ltd, Gedeon Richter (UK) Ltd, Imported (Germany), Lexon (UK) Ltd, Medihealth (Northern) Ltd, Necessity Supplies Ltd, Norgine Pharmaceuticals Ltd, Novo Nordisk Ltd, Orion Pharma (UK) Ltd, Pfizer Ltd, Pilsco Ltd, Sandoz Ltd, Sigma Pharmaceuticals Plc, Special Order, Sun Pharma UK Ltd, Theramex HQ UK Ltd, Viatris UK Healthcare Ltd. In the last twelve months 0 packs were listed and 3 discontinued. Every pack, its GTIN and published list price, and each week's changes are in the full report.

A listing in the NHS Dictionary of Medicines and Devices means a product may be supplied. It says nothing about sales or market share, and the list price is the reimbursement price, not what any buyer pays. Contains information from dm+d 10.1.0, published by the NHS Business Services Authority under the Open Government Licence v3.0.

Where it's prescribed · England

Estradiol across all 36 ICBs.

Every Integrated Care Board in England, shaded by how much estradiol its GPs dispense per head of population. Hover an ICB to name it. The ranked figures for all 36 ICBs, and the drill-down to practice level, are in the full report.

NHS Cheshire and Merseyside ICBNHS Staffordshire and Stoke-on-Trent ICBNHS Shropshire, Telford and Wrekin ICBNHS Lincolnshire ICBNHS Leicester, Leicestershire and Rutland ICBNHS Coventry and Warwickshire ICBNHS Herefordshire and Worcestershire ICBNHS North East London ICBNHS South East London ICBNHS South West London ICBNHS Kent and Medway ICBNHS Cornwall and the Isles of Scilly ICBNHS Devon ICBNHS Somerset ICBNHS Bristol, North Somerset and South Gloucestershire ICBNHS Bath and North East Somerset, Swindon and Wiltshire ICBNHS Dorset ICBNHS Gloucestershire ICBNHS Lancashire and South Cumbria ICBNHS North East and North Cumbria ICBNHS Humber and North Yorkshire ICBNHS West Yorkshire ICBNHS Birmingham and Solihull ICBNHS Greater Manchester ICBNHS Derby and Derbyshire ICBNHS Northamptonshire ICBNHS Nottingham and Nottinghamshire ICBNHS South Yorkshire ICBNHS Black Country ICBNHS Central East ICBNHS Essex ICBNHS Hampshire and Isle of Wight ICBNHS Norfolk and Suffolk ICBNHS Surrey and Sussex ICBNHS Thames Valley ICBNHS West and North London ICB
Items per 1,000 registered patients, 12 months
FewerMore

Darker shading marks where Estradiol is dispensed most per head of population. Exact figures for every ICB, and the drill-down to practice level, are in the full report.

Data: NHSBSA English Prescribing Data (OGL v3.0). Boundaries: ONS Open Geography portal, ICBs April 2026, contains OS data © Crown copyright and database right 2026.

Zoomed out to the 7 NHS regions.

The same 12 months rolled up to NHS England's seven regions, ranked by intensity.

North WestMidlandsMidlandsMidlandsMidlandsMidlandsMidlandsLondonLondonLondonSouth EastSouth WestSouth WestSouth WestSouth WestSouth WestSouth WestSouth WestNorth WestNorth East and YorkshireNorth East and YorkshireNorth East and YorkshireMidlandsNorth WestMidlandsMidlandsMidlandsNorth East and YorkshireMidlandsEast of EnglandEast of EnglandSouth EastEast of EnglandSouth EastSouth EastLondon
Items per 1,000 registered patients, 12 months
South West
South East
East of England
North West
Midlands
North East and Yorkshire
London
Data: NHSBSA English Prescribing Data (OGL v3.0). Regions: ONS Open Geography portal, NHS England regions April 2026. Contains OS data © Crown copyright and database right 2026.
Top 3 previews

The teaser view.

Three rows each. The full 36-ICB view, every prescribing organisation, every strength and the hospital picture sit below the fold, behind Apply.

Top ICBs by volume
  1. 1 NHS Surrey and Sussex ICB 646k
  2. 2 NHS Central East ICB 470k
  3. 3 NHS Thames Valley ICB 453k
  4. – + 33 more. See the full 36-ICB table. See all →
Fastest-growing ICBs (YoY)
  1. 1 NHS North East London ICB +21.9%
  2. 2 NHS Lincolnshire ICB +19.3%
  3. 3 NHS South East London ICB +18.6%
  4. – + 33 more. See every ICB, ranked. See all →
Top formulations
  1. 1 Estradiol 0.06% gel (750microgram per actuation) 18%
  2. 2 Estradiol 10microgram pessaries 16%
  3. 3 Oestrogel Pump-Pack 0.06% gel 15%
  4. – + 3 more. See every strength and pack. See all →
Primary vs secondary care
Primary 99% Hospital 1%

Split of items across NHSBSA primary care and SCMD hospital dispensing.

Deprivation · IMD 2019

Prescribing by deprivation.

Items per 1,000 registered patients by IMD decile: 1 = most deprived, 10 = least
178.4 0 12345678910

Items per 1,000 registered patients by deprivation decile (1 = most deprived), practice deprivation weighted by where each practice's patients live. Read the shape rather than the absolute level: the most and least deprived deciles cover far fewer practices, and age structure drives much of the gradient.

Beyond England

The devolved nations.

NationItems · 12 monthsData to
England 8.9m July 2026
Scotland 833k June 2026
Northern Ireland 320k May 2026
Wales 526k April 2026

Each nation publishes its own community prescribing data, with different coding and list rules, so read these per-nation rather than as an exact UK total. Sources: NHSBSA (England), Public Health Scotland, NHS Wales Shared Services Partnership, OpenDataNI. Used under the Open Government Licence v3.0.

Honesty strip

What open data won't tell you about estradiol.

Demand outran supply more than once in recent years, so parts of this trend show what pharmacies could dispense, not what women wanted. Systemic and local oestrogen also share this line, which blurs dose comparisons.

Read exactly what the data covers →

Common questions

Asked and answered.

Is estradiol prescribing rising or falling in the NHS?

Rising. England dispensed 8,916,608 items of Estradiol in the 12 months to July 2026, up 14.8% on the previous 12 months. Items count prescriptions dispensed, not patients treated, so the change can reflect dose and duration shifts as well as patient numbers.

How much does the NHS spend on estradiol?

£134.8m at net ingredient cost in the 12 months to July 2026. Net ingredient cost is the list price of the medicine before discounts and rebates; the NHS's final bill, especially for hospital medicines, is usually lower.

Where in England is estradiol prescribed most?

By raw volume, NHS Surrey and Sussex ICB dispensed the most estradiol in the last 12 months. Raw volume favours the biggest populations; the map on this page shades every ICB by items per head to correct for that.

How up to date is this data?

This page runs to July 2026, the most recent NHSBSA release. Prescribing data publishes roughly six to eight weeks in arrears, and DoseTrend refreshes within 48 hours of each monthly release.

Locked · Applicants only

The full breakdown.

Every ICB, every prescribing organisation, every strength, the hospital view with what trusts paid and who holds each framework line, Signals with their sources, and the monthly briefing PDF. The rows below are placeholders; the real tables sit behind the application.

Locked · Applicants only

See the full picture for Estradiol.

All 36 ICBs, prescribing organisations, formulation splits, Signals, and the hospital view with what trusts paid. Plus who won the NHS contract: 2 estradiol framework lines, 4 suppliers. £1,500 a month per molecule, price published, applications reviewed by a human within one working day.

No card details to apply. About one applicant in ten gets told the open data can't answer their question, before paying anything.

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Molecules in the same class

Related pages.

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