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The NHS Business Services Authority (NHS BSA) has estimated that patients who purchased a 12-month NHS prepayment certificate (PPC) may have saved almost £500m in prescription costs.
In an experimental analysis of prescription data from 2024/2025, published on 27 January 2026, NHS BSA identified 3.4 million patients who had received NHS prescriptions where a PPC was applied.
It estimated that these prescriptions could have cost patients £883m in prescription charges if they did not have a PPC.
“By assuming that these patients all purchased a 12-month PPC, we estimated they could have saved £499m on prescription charges after the cost of the certificate has been applied,” the NHS BSA report said.
Analysis of 2023/2024 data suggested that patients may have spent £817m without a PPC and may have saved £451m with a PPC.
NHS BSA added that it had identified 616,000 patients with an HRT PPC — up from 466,000 patients in 2023/2024 — who could have spent £33.4m without one and may have saved £21.2m after the cost of the PPC had been applied.
Most of the analysis focuses on data for 2024/2025. At the time, the charge for a single prescription was £9.90; a 3-month PPC cost £32.05; a 12-month PPC cost £114.50; and a 12-month HRT PPC cost £19.80.
“Figures for numbers of certificates issued should not be interpreted as numbers of people, as a unique individual could be represented multiple times,” the NHS BSA noted.
“Potential savings should not be added together since patients could appear in both PPC and HRT PPC groups.”
The analysis also showed that some patients are still paying more in prescription charges than the annual cost of a PPC.
“Although more and more PPCs are being issued each year, some patients paid for 12 or more prescription items or 3 or more HRT PPC eligible prescription items. This is more in prescription charges than the cost of an annual certificate,” the report said.
Amandeep Doll, director for England at the Royal Pharmaceutical Society (RPS), commented: [The data show] how significant prescription charges are for people who rely on regular medicines. PPCs can help some patients manage costs, but many patients are still left navigating a complex system and worrying about how much their medicines will cost.
“Pharmacists regularly speak to people who are deciding which prescribed items they can afford and which they may have to go without. No one should face a financial barrier to medicines a healthcare professional has prescribed as necessary. When people can’t afford their medicines, their health can worsen, increasing the risk of hospital admissions and piling pressures on other parts of the NHS.
“Prescriptions are free in Scotland, Wales and Northern Ireland. If they were free in England too then no one would have to worry about payment decisions affecting their health,” she added.
In November 2025, the government announced that prescription charges in England would be frozen for 2026/2027.
The results of a RPS survey, published in 2023, found that half of pharmacists had reported an increase in patients being unable to afford prescription medicines.
