NHS HRT Prescription Scheme - What You Need to Know - Stella
7 mins

NHS HRT prescription scheme – what you need to know

byDr. Lucy Wilkinson

The prepayment certificate (PPC) for HRT users in England helps hundreds of thousands of people get hold of cheaper medication. Stella’s clinical advisor Dr Lucy Wilkinson explains how the scheme works, how to find out if you’re eligible and how to access it.

What is the prepayment certificate for HRT?

The government launched the prepayment certificate for HRT in April 2023. 

It gives HRT users in England access to a full year’s supply of HRT for the cost of two individual NHS prescription charges (£19.30). 

NHS prescription charges are applied to every prescription issued. This is a flat fee of £9.65 per item, regardless of what it is and how much it costs the NHS to buy from the supplier.

These prescription fees can quickly add up. For example, if you take HRT in the form of an oestrogen spray and progesterone tablets, you need two prescriptions each month, which costs £19.30, regardless of whether you are prescribed one, three or six months supply at a time. Over the course of a year this could add up to over £200, and that’s assuming you don’t need to switch medications at any point.

It’s easy to see how HRT can become a financial strain. The aim of the prepayment certificate is to combat this, and to ‘improve the lives of millions of women in England who suffer from negative symptoms of the menopause’ as part of the Women’s Health Strategy for England.

Who is eligible?

The scheme covers patients in England who use HRT from a list of specified products including oral, transdermal and vaginal HRT.

Be aware that the HRT prepayment certificate may not be the best value option available for you. If you take medications for any other conditions, a different type of prepayment certificate (discussed below) might work out cheaper.

Likewise, you may be eligible for free prescriptions. This is the case if you are on certain benefits, if you are over 60 or if you have particular medical conditions.

Check if you are eligible for free prescriptions.

Prescriptions are free for everyone in Scotland, Wales and Northern Ireland.

Which types of HRT are covered by the HRT prepayment certificate?

There is a list of products covered by the HRT prepayment certificate. These include oral, transdermal and vaginal HRT. Brands covered at the time of writing are:

  • Bedol
  • Bijuve
  • Blissel
  • Climanor
  • Clinorette
  • Elleste Duet
  • Elleste Duet Conti
  • Elleste Solo
  • Estraderm MX
  • Estradot
  • Estring
  • Estriol
  • Ethinylestradiol 10mcg
  • Evorel
  • Evorel Conti
  • Evorel Sequi
  • Femoston
  • Femoston Conti
  • Femseven
  • Femseven Conti
  • Femseven Sequi Phase 1
  • Femseven Sequi Phase 2
  • Gepretix
  • Gina
  • Imvaggis
  • Indivina
  • Intrarosa
  • Kliofem
  • Kliovance
  • Lenzetto
  • Livial
  • Mirena
  • Novofem
  • Oestrogel
  • Ovestin
  • Premarin
  • Premique low dose
  • Progynova
  • Progynova TS
  • Sandrena
  • Tridestra
  • Trisequens
  • Utrogestan
  • Vagifem
  • Vagirux
  • Zumenon

It’s worth noting that the scheme only covers licensed treatments. Testosterone – which is sometimes prescribed off-label for certain symptoms of menopause – is therefore not currently included.

Does this mean I will get a 12-month supply of HRT all in one go?

No. For many HRT users, there is an initial three-month trial of any new form of HRT. This will be followed by a medical review and potentially a longer prescription if all is well.

Do I still need regular checkups?

Yes. You should still attend for reviews with your doctor as needed.

For most HRT users, this means an initial review appointment after three months on any new medication, plus follow-up appointments as needed.

Once established on HRT, you will still need an annual review appointment with your doctor. At this point, they will review your prescription and check that HRT is still the right treatment for you.

Are private prescriptions included?

No. Private prescriptions aren’t be included in this scheme.

What if I am on other medication besides HRT?

If you’re on other medication, it’s likely to be cheaper for you to consider one of the NHS’s other prescription prepayment certificates (PPCs), which have been operating for many years. 

You can buy a three month certificate for £30.25 or a 12-month certificate for £108.10. This covers all of the NHS prescriptions you need for that period of time. So, if you need one or more prescription items per month, you’ll save money. This is especially noticeable if you need two or more items per month, with savings running into hundreds of pounds.

These PPCs cover both HRT and other medications so are a good solution if you need HRT and another form of medication on a regular basis.

What happens if I change my HRT?

Your new HRT will be covered. There is no limit to the number of times you can use your certificate while it’s valid.

This means that changes to the type or dosage of your HRT will not leave you out of pocket. It’s common to need to change your HRT dose and type, especially while you are starting treatment.

How do I sign up for the HRT prepayment certificate?

You can apply via the NHS Business Service Authority online. Access their website here

You can also apply for the HRT prepayment certificate in-person at certain pharmacies.

How do I use the HRT prepayment certificate?

Once you have your prepayment certificate (either digital or on paper), show it to your pharmacist when you go to collect your prescription. 

You’ll then need to complete the exemption declaration on your prescription form. If you’re not sure how to do this, ask the pharmacist.

Final word

The HRT prescription prepayment certificate is good news for HRT users, but it’s important to ensure that it’s the best option for you.

Don’t forget to check if you are eligible for free prescriptions, or if another type of prepayment certificate might work out cheaper.

Find out more about menopause on our blog or in our symptoms library.