Premarin, a popular female hormone replacement therapy, has suddenly tripled in price, leading the Saskatchewan government to look at alternatives such as patches or gels.

"Yeah, it happened just basically overnight," Saskatoon pharmacist Greg Lazurko said of the price hike, which has left customers shaking their heads. "Something that may have cost $18 or $19 for a month or two is now upwards of $70 to $80 for the same quantities." 

Premarin is a synthetic estrogen pill made from the urine of a pregnant horse. It's offered to women to relieve the symptoms of menopause, such as hot flashes and night sweats, and was also once widely used to prevent heart disease and brittle bones.

The manufacturer, Wyeth Inc., confirmed it has raised the price due to higher production costs and a drop in demand.

The decline in sales has been partly attributed to a 2003 Women's Health Initiative that linked hormone replacement therapy to a greater risk of developing breast cancer.

Lazurko said about seven years ago, he was filling six to 10 prescriptions for  Premarin daily. Now he's down to one or two a month.

Customers are reacting with surprise and anger over the sudden price hike, said Lazurko.

"Some have said, 'Well you know maybe I just won't take it anymore,'" he said. "Or, 'I've been decreasing the dose anyway, so this might be a good time to stop.' It's understandable if someone would pick up their prescription, and see the change in price and be a little bit shocked or upset."

The director of the province's drug plan said Premarin is the only one of four different hormone replacement pills to go up in price. Dr. Vicki Holmes said the province may soon consider paying for alternatives, such as hormone patches or gel.

"There's good evidence that the topical estrogen is actually safer," she said.  "There are fewer incidents of blood clots."

The province has previously only paid for these alternatives when a patient couldn't tolerate the side-effects of pills.