Skip to main content
NCBI home page
The British Journal of General Practice logoLink to The British Journal of General Practice
. 1998 Feb;48(427):955–958.

Hormone replacement therapy: assessment of present use, costs, and trends.

J Townsend 1
PMCID: PMC1409983  PMID: 9624763

Abstract

BACKGROUND: Hormone replacement therapy (HRT) is probably unprecedented as a drug in widespread preventive use by a predominantly well population, but there is little direct data on current trends in use. AIM: To estimate trends in the use and cost of HRT in Britain. METHOD: Government prescription data and therapy cost data were analysed to provide trends in costs and point prevalence of the use of HRT since 1980. Projections were estimated to the year 2000. RESULTS: In 1987, HRT was used by an estimated 2.2% of women aged 40 to 64 years in England, and by 1.0% in Scotland. By 1994 this had risen to 21.7% in England, 20.4% in Scotland, and 21.3% in Wales. Between 1980 and 1986, costs remained steady at approximately 11 million Pounds per annum for England and 1 million Pounds for Scotland (1994 values). Between 1987 and 1994 they rose to 87 million Pounds for England, 10 million Pounds for Scotland, and 46 million Pounds for Wales (1994 values). Projections suggest that, by the year 2000, 25.4% of women aged 40 to 64 years (95% CI = 20.1-30.7%) will be taking HRT at any one time, at a cost of 150 million Pounds (95% CI = 142 m Pounds-157 m Pounds: 1994 values). This implies an 'ever' user prevalence of at least two-thirds of women in this age group. CONCLUSION: Use of HRT for long-term therapy is widespread and rising. It is estimated that prevalence has increased tenfold since 1987. Average individual costs of therapy have fallen by one third. The level of reduced risk of osteoporosis and cardiovascular disease, and the balance with cost and potential increased risk of breast cancer, are not yet established and are in need of clarification.

Full text

PDF
955

Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Adam S., Williams V., Vessey M. P. Cardiovascular disease and hormone replacement treatment: a pilot case-control study. Br Med J (Clin Res Ed) 1981 Apr 18;282(6272):1277–1278. doi: 10.1136/bmj.282.6272.1277. [DOI] [PMC free article] [PubMed] [Google Scholar]
  2. Belchetz P. E. Hormonal treatment of postmenopausal women. N Engl J Med. 1994 Apr 14;330(15):1062–1071. doi: 10.1056/NEJM199404143301508. [DOI] [PubMed] [Google Scholar]
  3. Colditz G. A., Hankinson S. E., Hunter D. J., Willett W. C., Manson J. E., Stampfer M. J., Hennekens C., Rosner B., Speizer F. E. The use of estrogens and progestins and the risk of breast cancer in postmenopausal women. N Engl J Med. 1995 Jun 15;332(24):1589–1593. doi: 10.1056/NEJM199506153322401. [DOI] [PubMed] [Google Scholar]
  4. Daly E., Roche M., Barlow D., Gray A., McPherson K., Vessey M. HRT: an analysis of benefits, risks and costs. Br Med Bull. 1992 Apr;48(2):368–400. doi: 10.1093/oxfordjournals.bmb.a072552. [DOI] [PubMed] [Google Scholar]
  5. Davidson N. E. Hormone-replacement therapy--breast versus heart versus bone. N Engl J Med. 1995 Jun 15;332(24):1638–1639. doi: 10.1056/NEJM199506153322409. [DOI] [PubMed] [Google Scholar]
  6. Effects of estrogen or estrogen/progestin regimens on heart disease risk factors in postmenopausal women. The Postmenopausal Estrogen/Progestin Interventions (PEPI) Trial. The Writing Group for the PEPI Trial. JAMA. 1995 Jan 18;273(3):199–208. [PubMed] [Google Scholar]
  7. Griffiths F., Convery B. Women's use of hormone replacement therapy for relief of menopausal symptoms, for prevention of osteoporosis, and after hysterectomy. Br J Gen Pract. 1995 Jul;45(396):355–358. [PMC free article] [PubMed] [Google Scholar]
  8. Hunt K., Vessey M. Long-term effects of postmenopausal hormone therapy. Br J Hosp Med. 1987 Nov;38(5):450-3, 456-60. [PubMed] [Google Scholar]
  9. Hunt K., Vessey M., McPherson K., Coleman M. Long-term surveillance of mortality and cancer incidence in women receiving hormone replacement therapy. Br J Obstet Gynaecol. 1987 Jul;94(7):620–635. doi: 10.1111/j.1471-0528.1987.tb03166.x. [DOI] [PubMed] [Google Scholar]
  10. Kennedy D. L., Baum C., Forbes M. B. Noncontraceptive estrogens and progestins: use patterns over time. Obstet Gynecol. 1985 Mar;65(3):441–446. [PubMed] [Google Scholar]
  12. Persson I., Adami H. O., Lindberg B. S., Johansson E. D., Manell P. Practice and patterns of estrogen treatment in climacteric women in a Swedish population. A descriptive epidemiological study. Part I. Acta Obstet Gynecol Scand. 1983;62(4):289–296. doi: 10.3109/00016348309156224. [DOI] [PubMed] [Google Scholar]
  13. Topo P., Klaukka T., Hemminki E., Uutela A. Use of hormone replacement therapy in 1976-89 by 45-64 year old Finnish women. J Epidemiol Community Health. 1991 Dec;45(4):277–280. doi: 10.1136/jech.45.4.277. [DOI] [PMC free article] [PubMed] [Google Scholar]
  14. Weiss N. S., Szekely D. R., Austin D. F. Increasing incidence of endometrial cancer in the United States. N Engl J Med. 1976 Jun 3;294(23):1259–1262. doi: 10.1056/NEJM197606032942303. [DOI] [PubMed] [Google Scholar]
  15. Wilkes H. C., Meade T. W. Hormone replacement therapy in general practice: a survey of doctors in the MRC's general practice research framework. BMJ. 1991 Jun 1;302(6788):1317–1320. doi: 10.1136/bmj.302.6788.1317. [DOI] [PMC free article] [PubMed] [Google Scholar]

Articles from The British Journal of General Practice are provided here courtesy of Royal College of General Practitioners

RESOURCES