NHS prescription charges in England

NHS Prescription charges

The NHS in England makes charges for certain treatments such as prescriptions. Currently, The National Health Service (Charges for Drugs and Appliances) Regulations 2015, as amended, made under powers conferred by the NHS Act 2006, make provision for prescription charges and exemptions in England.

From 1 May 2024, the medicine prescription charge in England is £9.90. On 28 April 2025, the government announced it would freeze prescription charges at this cost. The charges freeze also applies to prescription prepayment certificates and NHS wigs and fabric supports.

There is a broad system of exemptions from prescription charges, including for those on low incomes and people with some long-term medical conditions. The Department of Health and Social Care has said this means around 89% of NHS prescription items are dispensed in the community free of charge.

Prescriptions are free of charge in Scotland, Wales and Northern Ireland.

Who is entitled to free prescriptions?

Individuals are entitled to free prescriptions if they meet one or more of the following criteria:

• are under 16
• are 16 to 18 and in full-time education
• are 60 or over
• are pregnant or have had a baby in the previous 12 months and have a valid maternity exemption certificate (MatEx)
• have a specified medical condition and have a valid medical exemption certificate (MedEx)
• have a continuing physical disability that prevents them going out without help from another person and have a valid medical exemption certificate (MedEx)
• hold a valid war pension exemption certificate and the prescription is for an accepted disability
• are an NHS inpatient

Individuals are also entitled to free prescriptions if they hold a valid HC2 certificate (for full help with health costs).

Free prescriptions for those receiving benefits

Individuals are entitled to free prescriptions if they get at least one of the following benefits (or if they are included in the award of one of these benefits, such as the recipient’s partner, or a dependent under the age of 20):

• Income Support
• Income-based Jobseeker’s Allowance
• Income-related Employment and Support Allowance
• Pension Credit Guarantee Credit
• Universal Credit and meet the criteria

Medical conditions which exempt someone from prescription charges

Individuals are exempt from prescription charges if they have certain medical conditions and hold a valid medical exemption certificate.

A full list of conditions which entitle a person to exemption from prescription charges can be found on the NHS Business Services Authority webpage: Medical exemption certificates.

Patients with one of the specified medical conditions can apply for a medical exemption certificate from their GP. Further information on the process for obtaining a certificate is also available from the NHS Business Services Authority.

How to check eligibility for free prescriptions

The NHS has created an eligibility checker which can be used by an individual to work out if they are entitled for help with prescription costs.

If a patient claims for a free prescription that they are not entitled to, the NHS Business Services Authority can charge for the treatment retrospectively and can issue a penalty charge. The cost of a penalty charge is either £100 or five times the cost of the treatment (whichever is smaller), in addition to the original charge. Where a person fails to pay the penalty within 28 days, the penalty charge is increased by 50%.

Further help with prescription costs

If an individual is on a low income, they may qualify for help with health costs through the NHS Low Income scheme. This can help to pay for NHS prescription charges.

Individuals could also save money through a prescription pre-payment certificate (PPC). The National Health Service (Charges for Drugs and Appliances) (Amendment) Regulations 2024 sets out the costs of a PPC:

• A 3-month PPC costs £32.05 (saving an individual money if they need 4 or more prescribed items in 3 months)
• A 12-month PPC costs £114.50 (saving an individual money if they need 12 or more prescribed items in a year)

Full information on help with health costs is detailed on the NHS website – Help with health costs.

Hormone replacement therapy prescriptions

In April 2023, the then-Conservative government launched the hormone replacement therapy prescription pre-payment certificate (HRT PPC) to improve access to appropriate care for menopause. This followed the publication of the 10-year Women’s Health Strategy for England in August 2022, which included menopause as one its priority areas for improving women’s health and women’s experiences of healthcare.

The HRT PPC costs £19.80 per year, and gives patients access to unlimited HRT treatments on prescription. It saves individuals money if they receive over two prescribed qualifying HRT items in a year. The items that are covered by the HRT PPC are outlined by the NHS Business Services Authority, with further information given in Part XVI of the Drug Tariff.

Further information is available from the Department of Health and Social Care’s Introducing the HRT PPC: equality impact assessment (March 2023).

Proposed reform of prescription charge exemptions Medical exemptions

The list of medical exemptions from prescription charges was agreed in 1968. The only addition to the list since then has been the treatment of cancer in 2009.

In May 2010, the Department of Health and Social Care published the Gilmore Report, which was an independent review into prescription charges carried out by the then-President of the Royal College of Physicians, Professor Ian Gilmore. The review estimated that exempting people with long-term conditions from prescription charges would cost £430 million annually. In the 2010 Spending Review (PDF), the coalition government said no changes would be made to the list of medical exemptions, and this position has been confirmed by subsequent ministers.

The medical exemption list has been raised in Parliament in recent years, including in a March 2024 Westminster Hall debate on Prescription Charges: Long-Term Health Conditions, which was held in response to several e-petitions on the topic.

Prescription charge exemptions and the state pension age

On 3 September 2021 the government closed a consultation on Aligning the upper age for NHS prescription charge exemptions with the State Pension age.

The consultation put forward two possible options for change:

• Option A – to raise the qualifying age for free prescriptions to the SPA (currently 66) for everyone.
• Option B – to raise the qualifying age for free prescriptions to the SPA (currently 66) but with a period of protection, which would mean that people in the age range 60 to 65 would continue to receive free prescriptions.

In June 2023, the then-Conservative government announced the change would not go ahead; everyone aged 60 and over will continue to receive free prescriptions. The Labour government has said it does not plan to raise the upper age limit for prescription charges in line with the SPA.

Additional Reading

For future background for these and other NHS charges please see the House of Commons Library briefing NHS charges.

About the author: Hannah Burnett is a researcher specialising in health policy at the House of Commons Library.

Disclaimer

The Commons Library does not intend the information in this article to address the specific circumstances of any particular individual. We have published it to support the work of MPs. You should not rely upon it as legal or professional advice, or as a substitute for it. We do not accept any liability whatsoever for any errors, omissions or misstatements contained herein. You should consult a suitably qualified professional if you require specific advice or information. Read our briefing for information about sources of legal advice and help.