PPCs could have saved patients £499m on prescription charges last year

Prescription prepayment certificates (PPCs) could have saved patients up to £499m on prescription charges last year, according to experimental analysis by the NHS Business Services Authority (NHSBSA).

The report shows that in 2024/25, over 3.6 million certificates were issues and over 2.19 million of these were the 12-month PPC – with the uptake of these certificates seeing a consistent year-on-year increase since 2018/19.

Almost one million (984,000) three-month PPCs and 542,000 hormone replacement therapy (HRT) PPCs were also issued in 2024/25.

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Analysis is based on NHS prescriptions dispensed in the community in England and submitted to NHSBSA for reimbursement. This does not include prescriptions used in secondary care or prisons, issued by a private prescriber or non-prescription items sold over the counter.

Most of the analysis focuses on data for 2024/2025 when the prescription charges were as follows:

• Single item prescription charge: £9.90
• Three-month PPC: £32.05
• 12-month PPC: £114.50
• 12-month HRT PPC: £19.80

A three-month PPC will save money if a patient needs more than three prescribed items in three months. The 12-month PPC will save money if a patient needs more than 11 prescribed items in a year; and with an HRT PPC, patients save money if they buy three or more qualifying items in a year.

Although the number of PPCs being issued each year is increasing, some patients paid more in prescription charges than the cost of an annual certificate.

An estimated 881,000 patients could have saved around £36.4 million (£41 each on average) if they'd purchased a 12-month PPC, the NHSBSA said. And an estimated 209,000 patients could have saved around £5.8 million by purchasing an HRT PPC.

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Last August, dydrogesterone 10mg tablets were added to the list of medicines covered by the HRT PPC from 1 September 2025.

This expansion of medicines covered by the HRT PPC followed news that over 200,000 prescriptions were wrongly claimed using the HRT PPC between June 2024 and May 2025, according to the NHSBSA.

In November, Chancellor Rachel Reeves announced that the cost of a single prescription item would be frozen at £9.90 and three-month and annual PPCs would also be frozen for 2026/27.

Around 89% of prescriptions in England are already dispensed free of charge to children, over-60s, pregnant women, and those with certain medical conditions.

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At the time, CEO and executive chair of the Independent Pharmacies Association (IPA), Dr Leyla Hannbeck, responded: ‘Freezing the NHS prescription charge in England is good news for hard-pressed patients. But it should also act as a reminder that the fee patients pay is just that - a fee collected by pharmacists on behalf of the government. It doesn't relate to the actual cost to pharmacies of providing that medicine.

‘Instead, pharmacies hand over all the charges collected back to the NHS. They are then reimbursed for the medicines dispensed under a complicated formula, which too often sees pharmacies receiving less from the NHS than it costs them to buy the medicines.’