The new HRT pre-payment certificate is set to launch on 1 April – but many pharmacists aren’t sure about what it will involve. To answer your questions, here are five things we know about the certificate so far.

  1. It’s estimated to provide cheaper HRT to around 400,000 women

The new HRT pre-payment certificate (PPC) will cost the same as two single prescription charges – currently £18.70.

Health and Social Care Secretary Steve Barclay said that this will ‘make HRT more accessible than ever before - helping around 400,000 women save hundreds of pounds a year.’

  1. It can be used for unlimited HRT items over the course of a year

The certificate will be valid for twelve months, and can be used against any HRT items  licensed for use for menopause in the UK and listed on the HRT medicines list published in the Drug Tariff Part XVI.

  1. Patients will have to apply for it

DHSC said that women will need to apply for the PPC through the NHS Business Services Authority or in person at a pharmacy registered to sell PPCs.

Once it has been granted, it will be available for use immediately on or after 1 April 2023.

  1. Prescribers should issue HRT prescriptions separately – and contractors can refuse to dispense a mixed prescription

Prescribers are mandated to issue HRT prescriptions separately to prescriptions for other items, but if a patient with a valid HRT pre-payment certificate (PPC) presents a mixed prescription and asks to be exempted from HRT charges, the pharmacist may refuse to dispense the mixed prescription or may agree to dispense just the HRT or non-HRT items.

If this happens, patients should request new prescriptions for the items that are not dispensed. Alternatively, they can pay for all items and receive a FP57 receipt and refund form to claim back the charges paid for the HRT items covered by their HRT PPC.

  1. There will be an exemption category on pharmacy IT systems and paper prescription forms

Earlier this month, Cegedim Healthcare Solutions, which supplies the Pharmacy Manager PMR system, told The Pharmacist that for EPS Release 2 prescriptions, pharmacy staff will be required to manually select an exemption at prescription form level, as and when a prescription is received for an HRT medicine, and the patient has an HRT PPC, while paper scripts should be marked as ‘No Patient Charge’.

And Sima Jassal, pharmacist and Clinical Director for EMIS, told The Pharmacist that ProScript Connect will automatically carry out a check to determine if the patient has a valid HRT PPC on their record when an eligible HRT medicine is dispensed.

Where pharmacy IT systems have not yet been updated to implement the new HRT PPC, pharmacists should select the prescription prepayment certificate (PPC) exemption in the absence of the new HRT PPC exemption category, DHSC explained today.

Updated paper FP10s with the category ‘W’ for HRT PPC will be put into circulation from the beginning of April 2023 but old stock should be used until supplies are used up.

Guidance for workarounds where old prescription forms or tokens are presented, or dispensing systems have not been updated, will be issued in due course.

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