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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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14 Comments to “NHS England to review HRT charges”

  1. Are the new charges in place yet? If not, is there an indication of when they will be in place?

    Comment by GBown — March 17, 2022 #
    Reply

    1. @GBown, The new charges are not currently in place. As I understand it, the Women and Equalities Committee stated very recently that a new certificate will be introduced from next April, so presumably April 2023. However, increased awareness among GPs is in progress in order to raise awareness that prescription for annual duration of supply are possible but there remain concerns that this may create pressure on the supply chain.

      Comment by Matthew Robinson — March 17, 2022 #
      Reply

  2. My pre-payment certificate is coming up for renewal but it's only necessary because I have to pay for 2 x HRT preparations monthly. Can you confirm where NHS England is with its work on this topic and when we might have a firm date to work on for the annual charge? (Note I'm saying annual 'charge'…..it doesn't have to be an annual dispensing of medication, as this would inevitably affect supply chains. It's the paying of only one prescription charge that is the essential aspect. This really shouldn't be taking this long to sort out, considering Scotland and Wales already prescribe HRT free.

    Comment by Donna Robinson — February 17, 2022 #
    Reply

    1. @Donna Robinson,

      I'm sorry but I don't know any better than every one else where NHS England are up to sorting this out.

      Comment by Matthew Robinson — February 17, 2022 #
      Reply

  3. Does anyone know when the annual charge for HRT kicks in? I have to pay for 2 prescription costs each time currently.

    Comment by Clare — December 10, 2021 #
    Reply

    1. @Clare,

      NHS England will need to look into how this change can be implemented. I am not currently aware of any date when this will change.

      Comment by Matthew Robinson — December 10, 2021 #
      Reply

  4. I've just spoken to my Doctor, he knew nothing about this. I pay for 2 prescriptions and he would only prescribe 3 months. Why can't we pay one prescription cost and have the prescription that runs for 12 months, but only collect at 4 intervals through the year, this would help the supply chain?

    Comment by Sam Wilson — December 9, 2021 #
    Reply

    1. @Sam Wilson, This change will be of greater impact in pharmacies and to date has not yet been implemented by NHS England. So, I'm not surprised that your doctor wasn't aware of this. Also, supplying larger quantities now may increase short term supply chain problems to change needs to be carefully introduced.

      Comment by Matthew Robinson — December 10, 2021 #
      Reply

    2. You’re lucky. My GP will only prescribe one month and I take two different prescriptions for HRT. I’m also on two medications for arthritis which they will also only prescribe for one month. Almost £40 a month for medicine. I will soon be 60, so the charges will stop, but this will be a terrible drain on finances for many women.

      Comment by Janet Morrison — February 11, 2022 #
      Reply

      1. @Janet Morrison,

        It is fairly standard across the NHS to implement monthly prescribing. To help with health costs, there is a Pre-Payment Certificate. In your case, the three month option would save you £10 in the first month alone and prescriptions for the following 2 months would essentially be free.

        Comment by Matthew Robinson — February 12, 2022 #
        Reply

  5. 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 #
    Reply

    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 #
      Reply

  6. 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 #
    Reply

    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 once the patient is on a stable treatment.

      Comment by Matthew Robinson — November 1, 2021 #
      Reply

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