Reference
HRT prepayment certificate: what it actually saves
The NHS introduced a dedicated HRT Prescription Prepayment Certificate (HRT PPC) on 1 April 2023. It currently costs £19.80 and covers an unlimited number of listed HRT medicines for 12 months. Since a single NHS prescription item costs £9.90, the certificate pays for itself once you need 2 or more HRT prescriptions in a year.
Cost comparison
| Option | Cost | Notes |
|---|---|---|
| Pay per prescription | £9.90 per item | No certificate. Straightforward if you need HRT once or twice a year. |
| HRT Prepayment Certificate (HRT PPC) | £19.80 for 12 months | Covers an unlimited number of listed HRT items for a full year. Introduced 1 April 2023. |
| Standard 12-month PPC | £114.50 for 12 months | Covers all NHS prescriptions, not just HRT. Only worth it on cost grounds if you also need 12 or more non-HRT items a year. |
Figures for 2026/27: single prescription charge £9.90, HRT PPC £19.80, standard 12-month PPC £114.50, all frozen for the second year running. Source: NHS Business Services Authority and Community Pharmacy England.
What changed in 2023, and why it matters
Before 1 April 2023, anyone on regular HRT who wanted to avoid paying per item had only one option: the standard 12-month PPC at £114.50, which only makes sense if you're also filling 12 or more other prescriptions a year. Someone taking only HRT, needing it more than once or twice a year, had no cost-effective prepayment option. The dedicated HRT PPC closed that gap: for £19.80, exactly the cost of two single prescriptions, it covers a full year of listed HRT items.
One caveat worth knowing: the HRT PPC only covers items on the NHS's specific listed-HRT-medicines list. If you're also on unrelated regular prescriptions, work out your total item count across the year before assuming the HRT-specific certificate is the cheaper choice overall; the standard 12-month PPC may still work out better once combined.
The HRT PPC was introduced 1 April 2023. For NICE's own clinical guidance on HRT and when it's been updated, see our NICE and NHS guidance updates tracker.
Where to get it
The HRT PPC is applied for and managed directly through the NHS Business Services Authority, not through Her Vitals or any product we mention on this site. See the NHSBSA's own HRT PPC page to check current eligibility and apply.
Editor, Her Vitals
Oliver leads Her Vitals's editorial coverage of women's life-stage health and supplements. He curates and reviews existing branded products across trying to conceive, pregnancy, postnatal, perimenopause, menopause and the senior years, weighing what the evidence supports against guidance from bodies such as EFSA, the NHS and NICE, and is clear that the content is information rather than medical advice.
Published
Figures last checked against NHS Business Services Authority and Community Pharmacy England sources linked above.