NHS issues 500,000 HRT prepayment certificates since April 2023

The Department of Health and Social Care says HRT prescription prepayment certificates have saved patients more than £11m since their launch.
NHS prescription signage

More than 500,000 women in England have accessed hormone replacement therapy (HRT) using NHS prescription prepayment certificates (PPCs) since 1 April 2023, the government has announced.

In a statement from the Department of Health and Social Care (DHSC) on 24 January 2024, it was revealed that HRT PPCs have saved patients more than £11m since their launch.

The certificates reduce annual prescription costs to a flat rate of £19.30 per year and can be used against a list of eligible HRT items, including patches, tablets and topical preparations.

In the DHSC statement, Victoria Atkins, health secretary, said that better access to HRT “will improve the lives of millions and gives women the freedom to take control of their symptoms”.

The roll-out of the HRT PPC is part of a wider scheme of government initiatives under the ten-year ‘Women’s health strategy for England‘, which was launched in 2022.

Maria Caulfield, minister for women’s health strategy, said: “Many women often need to try a few different types of HRT to get the right medication that works for them. By reducing the price of HRT to under £20 for a year’s supply, we’ve made it more equitable for women to go on living their normal lives.”

Michael Brodie, chief executive of the NHS Business Services Authority (BSA), which is responsible for delivering the service, said: “This significant milestone highlights the crucial role this service provides for patients who rely on HRT, allowing them access to their medication at a reduced cost.” 

Tase Oputu, chair of the Royal Pharmaceutical Society’s (RPS) English Pharmacy Board, said: “The HRT prepayment certificate was a step forward for women in England by making vital medicines more affordable, but this doesn’t go far enough in addressing health inequalities.

“No one should face a financial barrier to getting the medicines they need. We want to see the prescription charge abolished for everyone so medicines are free to access in England, just as they are in the rest of the UK.”

Figures released by NHSBSA on 26 October 2023 show that 10.9 million HRT items were prescribed in England in 2022/2023 — a 47% increase from 7.4 million items in 2021/2022.

There have been major shortages of HRT since 2018, thought to be caused by a surge in demand as well as factors related to manufacturing capacity and disruption of global supply chains.

The National Institute for Health and Care Excellence (NICE) ran a consultation on its draft updated guidance on menopause diagnosis and management between 17 November 2023 and 5 January 2024, with results expected to be published on 13 May 2024.

In its response to the consultation, the Royal Pharmaceutical Society called for dydrogesterone — a progestogen used in HRT — to be included in the updated NICE guidance to “bring attention to a potentially underused treatment option”.

Last updated
The Pharmaceutical Journal, PJ, January 2024, Vol 312, No 7981;312(7981)::DOI:10.1211/PJ.2024.1.215409

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