Ahead of the Government's decision to introduce the new Prescription Prepayment Certificate (PPC) for Hormone Replacement Therapy (HRT) products on 1st April, Pharmacy teams have now received guidance to help implement this new policy.

From 1st April 2023, patients who are not already exempt from NHS prescription charges will be able to purchase an annual HRT PPC for the cost of two single prescription charges. This is in line with Government policy to make HRT medicines more accessible and it is a positive development for patients. Pharmacy representatives had argued that these medicines should be free.

Ahead of the launch of the HRT PPC, PSNC Chief Executive Janet Morrison said:

The HRT PPC being introduced by the Government next month is a positive development for patients – indeed, we argued that these medicines should have been made available for free – but NHS systems have not kept pace with policy, meaning the certificate is launching without the IT in place to support it. This is totally unacceptable: community pharmacies cannot on the one hand be subjected to funding cuts, but on the other hand be expected to keep picking up the pieces when DHSC and the NHS launch policies without having the infrastructure in place to effectively implement them..."

How will it work?

The HRT PPC can be used against any DHSC listed HRT medicine licensed for the treatment of menopause. The HRT PPC will be available to purchase through the NHS Business Services Authority (NHSBSA) website or from selected pharmacies.

Key Changes

As a consequence of its limited scope, a patient with and HRT PPC will continue to pay the prescription charge for any other (non-HRT) medicines (unless another exemption reason applies). While GPs will be required to write HRT items on separate prescriptions, on occasion both an HRT medicine and another item will be prescribed on the same prescription - a 'mixed' prescription. This presents a problem for a patient who has an HRT PPC and for the pharmacy because a prescription cannot be processed as both 'exempt' and 'paid' within the NHS prescription processing and pricing systems.

The Government has put Regulations in place seeking to avoid such 'mixed' prescriptions and to give options to pharmacists facing 'mixed' prescriptions presented by patients with an HRT PPC. The Government is advising pharmacies to refuse to dispense 'mixed' prescriptions to patients with an HRT PPC, unless the patient needs one or more of the prescriptions items urgently.

Information for patients

How much does an HRT PPC cost?

The Government has decided that the cost of an HRT PPC will be equivalent to two single prescription charges in England. From 1 April 2023, a single prescription charge is £9.65 per item and an HRT PPC will cost £19.30. A standard 3-month PPC will cost £31.25 and a standard 12-month PPC will cost £111.60.

How long is an HRT PPC valid for?

An HRT PPC is valid for 12 months from the start date and covers an unlimited number of listed HRT medicines.

Where can I find the most up to date list of HRT medicines covered by the HRT PPC?

The list of HRT medicines covered by the HRT PPC will be published in Part XVI of the NHS Drug Tariff from April 2023. The up-to-date HRT medicines list will also be available on the HRT PPC application page and the NHSBSA help with health costs page.

Can an HRT PPC be backdated?

Yes, the HRT PPC can be backdated by up to one month from the date of application (but not prior to 1 April 2023).

Where can patients purchase an HRT PPC from?

The quickest way for patients to buy an HRT PPC is online at www.nhsbsa.nhs.uk/hrt-ppc. It is optional for pharmacies to sell PPCs. PSNC recommends that patients visit the NHSBSA website to identify and purchase the PPC that is most suited for their needs.

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