Making HRT medicines free-of-charge items would be easier for pharmacy teams to implement and more cost-effective than the HRT pre-payment certificate, the Pharmaceutical Services Negotiating Committee (PSNC) has said.

The Royal Pharmaceutical Society (RPS) has also called for all prescription medicines to be free of charge to those with long-term conditions.

On Tuesday, the Department of Health and Social Care (DHSC) confirmed that the HRT pre-payment certificate would be available from 1 April, giving patients access to a year’s supply of HRT items for the menopause for less than £20.

However, PSNC warned that the PPC might not work well with existing prescription processing and pricing systems currently used in England.

It also said that implementing a new type of PPC would add to community pharmacies’ workload and introduce financial risks for community pharmacy teams.

Instead, it proposed that HRT medicines be made free-of-charge items (in a similar way to contraceptives) which ‘would make it easier to implement and more cost-effective’.

PSNC said that it highlighted these concerns to ministers in November 2022 and said that while the government had recognised the issues, ‘the Minister has decided to press ahead with the policy’.

PSNC said that it was working with the Department of Health and Social Care (DHSC) to understand what actions will be required by pharmacy contractors and to try to mitigate the issues.

Meanwhile, Thorrun Govind, RPS England chair, welcomed the introduction of the PPC making HRT more affordable but said ‘it remains inequitable that people with other long term conditions still have to pay the prescription charge which is in effect an unfair tax on health’.

She added: ‘No one should face a financial barrier to getting the medicines they need. We want to see the prescription charge abolished for everyone with long-term conditions so medicines are free to access in England, just as they are in the rest of the UK.’

In particular, PSNC raised concerns that patients could experience difficulties if the HRT prescription is not written on a separate prescription to other paid prescription items.

Prescribers are mandated to issue HRT prescriptions separately to prescriptions for other items, but if a patient with a valid HRT 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.

But one pharmacist warned that they would not be able to issue a refund since the FP57 receipt does not detail which items the payment covered.

PSNC said that it understood that DHSC would issue further communication materials to support pharmacy teams with the roll-out of the HRT PPC.

The Pharmacist has approached DHSC for comment.