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Prescribing Advice for GPs

An NHS Prescribing Advisers' Blog

NHS England to review HRT charges

As reported in the general media (BBC), NHS England are to review how prescriptions charges are applied to prescription for Hormone Replacement Therapy treatments.

The current NHS prescription levy is £9.35 with 3 and 12 month Prepayment Certificates available to assist people on regular medication. HRT however has always been an area that causes some confusion, some treatments that contain 2 different treatment regimens is charged at two fees, so £18.70.

It is being proposed that fees are charged on an annual basis irrespective of the treatment used or how it is prescribed. It is noted in the linked article that prescription duration also plays a part with some areas issuing monthly prescriptions. NHS England are being asked to investigate what changes can be made to implement the charging changes. Prescriptions are already free in Scotland and Wales.

Action: Clinicians should be aware of this imminent change. In the short term, clinicians may wish to consider issuing extended durations of supply, perhaps 6 or 12 months of treatment to women established and stable on their preferred treatment.

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4 Comments to “NHS England to review HRT charges”

  1. I would just be wary of a wholesale increase to duration of treatment, due to the supply issues we experienced earlier in the year with many HRT preparations. If every patient went to a pharmacy with 6 or 12 months prescribed, the supply chain in the short term probably wouldn't cope with the demand. Work is underway to look how this directive can be implemented, taking into account impacts on prescribers, dispensers and the supply chain.

    Comment by Darren Powell — November 1, 2021 #

    1. @Darren,

      It's a fair point about the supply chain. It does seem in the last few months that the issues seen earlier seem to have settled. Hopefully the manufacturers will be aware of this potential change and will be working on ensuring continued supply.

      Comment by Matthew Robinson — November 1, 2021 #

  2. Patients who pay for prescriptions will not be happy to have first script of shorter duration. "Established and stable" can only be done by one or 3 months script.

    Comment by Dr Bhatt — November 1, 2021 #

    1. @Dr Bhatt,

      I'm not sure I understand the point you are trying to make. It is not unreasonable to supply a short course while finding the right treatment. And in the locality where I work we routinely supply HRT and contraception for 6 or 12 months at a time.

      Comment by Matthew Robinson — November 1, 2021 #

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