HRT prepayment certificate: £19.80 for 12 months of listed HRT

What the HRT PPC is

The hormone replacement therapy prescription prepayment certificate is a £19.80 certificate from the NHS Business Services Authority (NHSBSA) covering an unlimited number of listed HRT medicines for 12 months in England. The price equals two standard prescription charges at £9.90. It applies only in England, because Scotland, Wales and Northern Ireland have no prescription charge.

The certificate covers listed medicines whatever the reason for the prescription. The NHSBSA says the covered medicines are not limited by the condition they are prescribed for.

Which medicines are covered

The NHSBSA keeps a list on its website, last changed on 1 July 2026. It covers these brands, and generic versions where the generic drug name appears on the prescription:

• Angeliq
• Bijuve (also spelt Bijuva), Blissel
• Elleste Duet, Elleste Duet Conti, Elleste Solo, Estraderm MX, Estradot, Estradot Conti, Estring (90-day preparation), Evorel, Evorel Conti, Evorel Gel, Evorel Sequi
• Femoston, Femoston Conti, Femseven, Femseven Conti
• Gepretix, Gina
• Imvaggis, Indivina, Intrarosa
• Kliofem, Kliovance
• Lenzetto, Livial
• Nalvee, Novofem
• Oestrogel, Ovesse
• Premarin, Premique Low Dose, Progynova, Progynova TS
• Sandrena
• Trisequens
• Utrogestan
• Vagifem, Vagirux
• Zumenon

Non-branded products not listed by name are covered where the generic name is on the form. Premarin and Premique Low Dose remain covered while existing stock lasts. Mirena is on the list but is free anyway as a contraceptive, so no charge applies even when prescribed for the menopause.

Medicines not licensed for the menopause in the UK are excluded, even when a GP prescribes them for menopause symptoms. If your medicine is not on the list, the NHSBSA says to check with your GP or pharmacist before buying.

Who should buy one

Anyone in England who pays the £9.90 charge and expects to collect listed HRT medicines 3 or more times in 12 months. Before buying, check whether you already get free prescriptions. People aged 60 or over, people with a medical exemption certificate and people on qualifying benefits pay nothing and gain nothing from the certificate. The free prescriptions guide has the full list.

Worked saving

Three HRT items in 12 months cost £29.70 at the counter against £19.80 on the certificate, a saving of £9.90. A woman collecting one HRT item a month pays £118.80 a year without a certificate and £19.80 with one, a saving of £99. Two HRT items a month, for example an oestrogen gel and a progesterone capsule, cost £237.60 a year at the counter, so the certificate saves £217.80.

When a standard PPC is better

The HRT PPC only covers listed HRT. Other prescriptions still cost £9.90 each. The NHSBSA gives two tests for switching to the standard certificate: 4 or more items in 3 months with at least 2 not HRT, or 12 or more items in 12 months with at least 10 not HRT. The standard 3-month PPC costs £32.05 and the 12-month costs £114.50, and both cover every item including HRT.

The NHSBSA PPC page gives a combined example. An HRT PPC at £19.80 plus one standard charge at £9.90 totals £29.70, which is less than a 3-month PPC at £32.05. So a woman with HRT plus one other item a quarter does better with the HRT certificate. With HRT plus two other items a quarter the total is £39.60 and the 3-month PPC wins. The standard PPC guide and the PPC calculator work the non-HRT side.

How to buy

1. Go to the NHSBSA website and use the online Buy an HRT PPC service, or buy in person at a pharmacy that sells them. The phone line for queries is 0300 330 2089, open Monday to Friday 8am to 6pm and Saturday 9am to 3pm.
2. Choose a start date. The NHSBSA allows a date up to one calendar month before or one month after the purchase date. If your next HRT collection is more than a month away, the NHSBSA suggests buying nearer the time.
3. Pay £19.80 by card. Direct Debit is not offered.
4. The certificate is sent by email. You can print or download it. Check the details match the name on your prescriptions, because a mismatch can lead to a penalty charge.
5. Tick the HRT PPC box on the back of each prescription and sign.

Refunds

The certificate fee is non-refundable. The NHSBSA states this applies even if your circumstances change, which separates the HRT PPC from the standard PPC, where leaflet HC11 allows proportional refunds when you become exempt.

Refunds of individual charges work the same way as any prescription. Collect form FP57 when you pay, make sure the certificate covers the date of payment and the medicine, and claim within 3 months. The prescription refund guide sets out the steps.

Mistakes that cost money

Buying the certificate before checking the medicine is on the list. A charge for an unlisted item is not refundable against the HRT PPC.

Buying the HRT PPC when a standard PPC would cover everything. Someone on HRT plus a statin, a blood pressure tablet and an inhaler pays £19.80 plus £9.90 for every other item. A 12-month PPC at £114.50 covers the lot.

Buying the certificate too early. A start date a month before purchase recovers earlier charges only if you kept the FP57 forms. A start date a month after purchase delays cover without saving anything.

Setting up a 3-month PPC each quarter for HRT alone. Four quarters at £32.05 cost £128.20 against £19.80.

Where the figures come from

The £19.80 price, the 12-month validity, the one-month start window, the no-refund rule, the two tests for when a standard PPC is better and the phone line are from the NHSBSA HRT PPC page. The medicines list is from the NHSBSA covered medicines page dated 1 July 2026. The standard PPC prices and the combined £29.70 example are from the NHSBSA PPC page. The £9.90 charge is from the NHS website. PPC refund rules are from leaflet HC11 (V28), April 2026.