Canadian menopausal hormone therapy dispensing increased from 2018 to 2023

A retrospective time-series study published in Menopause examined menopausal hormone therapy (MHT) dispensing across Canadian provinces from December 2017 to November 2023 using IQVIA CompuScript data. Researchers standardized oral, transdermal and vaginal formulations to World Health Organization defined daily doses (DDD), reporting dispensing per 1,000 women per day using provincial populations of women aged 45–65 years as the denominator. The study addressed limited contemporary data on Canadian MHT use and provincial variation.

National dispensing increased from 59.1 to 83.4 DDD per 1,000 women per day. Vaginal MHT rose from 14.9 to 29.2 and transdermal MHT from 18.4 to 26.8, while oral MHT remained relatively stable at 25.8 to 27.3. In 2023, Quebec recorded the highest rate, at 162 DDD per 1,000 women per day, followed by British Columbia at 84.3 and Nova Scotia at 83.1.

The authors suggest that more comprehensive drug coverage may partly explain Quebec’s higher dispensing rate, but this explanation is not established by the findings. These aggregate dispensing measures describe utilization rather than individual treatment eligibility, adherence or clinical outcomes. The results identify formulation-specific and geographic differences relevant to menopause care and further research on access to treatment.