How to save money on hormone replacement therapy prescriptions in 2026

If you pay for prescriptions in England and use hormone replacement therapy, the cost can build up over time. To help reduce this cost, the NHS introduced a dedicated hormone replacement therapy prescription prepayment certificate. This guide explains what the certificate is, why it was introduced and how it can help you save money.

Why the hormone replacement therapy certificate was introduced

Hormone replacement therapy is a treatment used by millions of people to manage symptoms associated with perimenopause and menopause. In 2023 and 2024, around 2.6 million people in England were taking hormone replacement therapy, and that number has been rising steadily in recent years, with prescriptions reaching millions of items each year. 

Unlike some other long term conditions, hormone replacement therapy does not automatically qualify for free prescriptions. Before the certificate was introduced, people could end up paying the standard prescription charge every time they collected their medication. For those needing multiple items or repeat prescriptions throughout the year, this could be expensive.

The hormone replacement therapy prescription prepayment certificate was introduced to make treatment more affordable and to reduce financial pressure for people managing menopause symptoms.

Current prescription costs in England

The standard charge for each prescription item in England is £9.90.

There are two main ways to pay in advance if you need prescriptions regularly:

Hormone replacement therapy prescription prepayment certificate

This costs £19.80 and covers eligible hormone replacement therapy medicines for 12 months.

Prescription prepayment certificate

This covers all NHS prescriptions. It costs £32.05 for three months, or £114.50 for 12 months.

You can check the latest prescription charges here:
https://www.nhsbsa.nhs.uk/help-nhs-prescription-costs

These prices are frozen for the 2026 to 2027 financial year.

What the hormone replacement therapy prescription prepayment certificate is

The hormone replacement therapy prescription prepayment certificate works like a season ticket.

Instead of paying £9.90 each time you collect an eligible hormone replacement therapy medicine, you pay £19.80 once and your eligible prescriptions are covered for 12 months.

You can check which medicines are included here:
https://www.nhsbsa.nhs.uk/help-nhs-prescription-costs/nhs-hormone-replacement-therapy-prescription-prepayment-certificate-hrt-ppc

During that year, you can receive as many eligible hormone replacement therapy prescription items as you need without paying the standard charge each time.

How it helps

The certificate helps in several ways:

• It reduces the overall cost for many people who need more than two hormone replacement therapy prescriptions in a year
• It gives certainty about how much you will pay for the year
• It removes the need to pay at the pharmacy each time for eligible items
• It supports continued access to treatment by making it more affordable

For example:

• Two single prescription charges would cost £19.80
• If you need three or more eligible hormone replacement therapy prescriptions in a year, you are likely to save money with the certificate

Important things to know

• The certificate only covers eligible hormone replacement therapy medicines
• Not every hormone replacement therapy product is included, so it is important to check before buying
• It does not cover other types of medication

If you are prescribed other medicines as well, a general prescription prepayment certificate may offer better value. The 12 month general certificate costs £114.50 and covers all prescriptions.

Check if you qualify for free prescriptions

Before buying any certificate, check whether you are entitled to free prescriptions.

You may automatically qualify if you are:

• Under 16
• Aged 16 to 18 and in full time education
• Aged 60 or over
• Pregnant or have had a baby in the last 12 months
• Entitled because of certain medical conditions
• Entitled because of certain benefits

You can check your eligibility here:
https://www.nhsbsa.nhs.uk/check-if-youre-eligible-help

If you qualify for free prescriptions, you do not need to buy a prepayment certificate.

How to get a hormone replacement therapy prescription prepayment certificate

You can apply for a hormone replacement therapy prescription prepayment certificate in the following ways:

• Online through the Government website: https://www.gov.uk/get-a-ppc/hrt-ppc
• By telephone through the NHS Business Services Authority: 0300 330 2089
• In some pharmacies, where staff can help you apply

When applying, you will need your name, address, date of birth and payment details. You will also need an email address if you would like a digital confirmation

Once approved, your certificate usually starts straight away. You can choose a start date up to one month in the past if you have already paid for an eligible prescription.

With millions of people in England now using hormone replacement therapy, the prescription prepayment certificate can make a meaningful difference to yearly costs.

The best first step is to check whether you qualify for free prescriptions. If not, consider how many prescription items you collect in a year and choose the option that offers the best value for you.