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NHS prescription charge
Pharmacy insights

NHS prescription charge [2021/2022]

From the 1st of April 2020, the new NHS prescription charge is £9.35 for each item dispensed by a pharmacy. NHS prescription charge usually goes up every year in April. Patients need to pay a new prescription charge even when a prescription was prescribed before the 1st of April 2021 and collected on or after that day.

Summary of the post:

  • the annual increase in NHS prescription charges
  • Who is exempt from paying for NHS prescriptions? (list of exemptions)
  • Are all contraceptive free of charge?
  • List of all medical conditions covered by a medical exemption certificate
  • How to get a medical exemption certificate?
  • Paying for private prescriptions
  • Do students pay for NHS prescriptions?
  • NHS Prescription Prepayment Certificate (PPC)
  • How to get help with NHS prescription charges

NHS prescription charge: the annual increase in price

NHS prescription charge is increased every year on the 1st of April.

One would expect to see another increase on the 1st of April 2022.  

NHS prescription charge: who is exempt 

Not all patients need to pay NHS prescription charges when collecting their medication. When a patient/patient representative collects the drug, they are asked to sign the back of the prescription and tick an appropriate exemption. When none of the exemption applies to patients, they must pay the NHS prescription charge(s). 

Who is exempt from paying for prescriptions?

  • Exemption A: patients who are 60 years of age or over or is under 16 years of age
  • Exemption B: patients who are is 16, 17, or 18 and in full-time education
  • Exemption D: maternity exemption certificate applies to pregnant women or mothers who gave birth in the last 12 months. 
  • Exemption E: medical exemption certificate, which covers patients with various medical conditions, for example, diabetes. For a list of all conditions covered by a medical exemption, see the next paragraph. Medical exemption certificate covers the free supply of all medications on NHS prescription.  
  • Exemption F: Prescription prepayment Certificate (PPC). Patients can purchase PPC for 3 or 12 months (one-off payment or monthly direct debit). PPC covers all NH prescription charges. Generally, if one pays for two or more prescription charges a month, PPC becomes a cheaper option.
  • Exemption G: exemption issued by the Ministry of Defence, for example, patients who receive a war pension.  
  • Exemption L: HC2 certificate – patients who applied for the NHS Low Income Scheme and received a certificate covering full help of health costs. This exemption applies to partners and persons under 19 years of age who live in the same household.
  • Exemption H: Income Support (IS) or Income-related Employment and Support Allowance (ESA). IS and ESA also apply to partners and people dependant under the age of 20. 
  • Exemption K: patients and dependants under the age of 20 who receive Income-based Jobseeker’s Allowance. 
  • Exemption M: patients and any dependant under the age of 20 (who are included in their tax credit claim) who receive a Tax Credit exemption certificate. Tax credit claim covers patients who receive tax credits of £15,276 or less and receive a child tax credit, working tax credit together with a child tax credit or working tax credit, which includes a disability or severe disability part. 
  • Exemption S: patients and their partners who receive Pension Credit Guarantee Credit. 
  • Exemption U: patients who receive Universal Credit (UC) and earn £435 or less or £935 or less and their UA covers partly a child, or the patient has limited capability to work. 

Please note: you can be fained up to £100 if you claim free NHS prescriptions without entitlement to it.

Are all contraceptives free of charge?  

Exemption X is no longer present at the back of prescriptions. However, patients are automatically exempt from paying for contraceptives.

There is an exception to this rule, which applies to contraceptives, which can be used to treat acne. For example, co-cyprindiol 2000mcg/35mcg tablets (Dianette) is usually used for the treatment of acne. Patients are required to pay for Dianette unless a doctor endorses the prescription with “CC”, “OC” or the female symbol (♀).  

Medical exemption certificate – list of conditions covered

The following conditions are covered by a medical exemption certificate (NHS BSA, 2020): 

  • permanent fistula (for example, caecostomy, colostomy, laryngectomy or ileostomy) requiring continuous surgical dressing
  • hypoadrenalism (for example, Addison’s Disease) for which specific a substitution therapy is needed
  • diabetes insipidus and other forms of hypopituitarism
  • diabetes mellitus, unless treatment is by diet alone
  • hyperparathyroidism
  • myasthenia gravis
  • myxoedema (hypothyroidism which requires thyroid hormone replacement)
  • epilepsy, which requires continuous anti-convulsive therapy
  • a continuing physical disability which requires the help of another person
  • cancer patients: medical exemption for cancer patients lasts five years. 

How to get a medical exemption certificate? 

When a diagnosis is made for any of the above conditions, a doctor should advise patients about medical exemption and provide an FP92A form. A medical exemption certificate is usually backdated one month from the date the application is made. 

Paying for private prescriptions

Sometimes patients may bring a private prescription to the pharmacy after seeing a doctor in a private clinic. Patients may also be prescribed a limited number of drugs on a private prescription by NHS doctor, with the most common drug being sildenafil (for erectile dysfunction).

None of NHS exemptions excludes payments from paying for medication when a private prescription is brought to a pharmacy, regardless of patient’s age. A patient needs to pay for the cost of medication supplied, plus any additional fees. Learn more about private prescriptions.

Do students pay for NHS prescriptions? 

The above question is a valid question that often leads to misinterpretation of eligibility for free NHS prescriptions

As we learned from the previous paragraph, exemption B allows for free NHS prescriptions when the patient is 16, 17, or 18 and in full-time education.

You don’t have to pay for your prescriptions only if you are a student of a school, college, university, or similar institution and if you are 16-18 years of age. Students who are 19 years of age or older and study at university have to pay for prescriptions

Apprenticeship is also not covered by this exemption. 

How to get an exemption when you are a student 

As a student, you can apply for an HC2 certificate as a part of the NHS Low-Income Scheme to help cover various NHS charges, including NHS prescription charges. Other costs that you can get help with include: 

  • NHS dental treatments
  • The cost of eye check, contact lenses, or glasses 
  • The cost of travelling to get NHS treatment

Any student can apply, providing that one does not have savings, investments, or property worth more than £16000. In order to get an HC2 certificate, students must complete the HC1 form, which can be found on the NHS Service Business Authority website

A student who applies for an HC2 certificate will need to provide proof of all grants, loans, bursaries, and awards showing the amount of money received. A student loan will be treated as part of your income when an assessment for an HC2 certificate is made. It takes 18 days for the assessment to be completed. 

Prescription Prepayment Certificate for students

Save money with NHS prescription prepayment certificate

Alternatively, if you don’t qualify for the low-income scheme or prefer less hassle, you can purchase a prescription prepayment certificate (PPC). PPCcovers all NHS prescription charges for a set monthly price. See more details in the latter part of this post.   

NHS prescription charge: single and multiple charges

As stated, patients pay £9.35 per each item prescribed on NHS prescription. There are exemptions to this rule, however. For example:  

  • One drug prescribed twice in the same formulation (for example, tablets) on one prescription carries only one charge. For example, Sertraline 50mg tablets and sertraline 100mg tablets prescribed on one prescription would cost the patient £9.35.
  • One drug prescribed twice in a different formulation carries two charges. For example, Ramipril 5mg tablets and ramipril 2.5mg capsules prescribed on one prescription would bring two prescription charges: £9.35 x 2 = £18.70
  • Some drugs carry two NHS prescription charges, even though one item is prescribed on prescription. For example, a combination product used for thrush treatment, Canesten Thrush Combi (one product that contains the drug in two different formulations. In this case, a pessary and external cream carry two charges (it would be cheaper to buy over the counter without a prescription). 
  • Some common drugs which carry two NHS prescription charges include:
    • Canesten Combi Pessary & Cream
    • Canesten Oral & Cream Duo
    • Migraleve (combination pack)
    • Evorel Sequi patches
    • Femoston 1/10mg
    • Femoston 2/10mg
    • FemSeven Sequi patches
    • One pair of stocking

Lis of all items which carry two or three NHS prescription charges can be found on the PSNC website.

NHS prescription prepayment certificate

Patients who have two or more items prescribed regularly can save money with an NHS prescription prepayment certificate (PPC). A patient who signs up for PPC pays a set amount for the certificate, which covers all NHS prescription charges.

This year there was a small increase in prices for PPC, which currently stand at:

  • £30.25 for three months (increase by £0.60)
  • £108.10 for 12 months (increase by £2.20)

12-months PPC is usually set up with 10 monthly payments by direct debit.

NHS Prepayment Certificate can be easily purchased online, over the phone, or in some pharmacies. Read more about NHS Prepayment Certificate in my separate post.

Patients who are not sure about their exemption status should pay the charge and ask for a receipt (FP57 form) at the point of payment (FP57 cannot be requested on a different day or time). FP57 can be used to get a refund for a paid prescription charge(s), once for example, NHS PPC is set up.

Help with NHS prescription charges

Visit the NHS website ‘Help with health costs‘ to learn about other options to get help with health costs, for example, prescription charges.


How much is an NHS prescription 2019?

In 2019 the cost for NHS prescription was £9.00. NHS prescription charge usually increases every year on the 1st of April.

How much is an NHS prescription 2020?

From the 1st of April 2020, the cost for each item prescribed on NHS prescription is £9.15. NHS prescription charge usually increases every year on the 1st of April.

Are NHS prescriptions free for over 60s?

Yes, in the UK, patients aged 60 and over get NHS prescriptions for free.

Do you pay per prescription or item?

In the UK, patients pay NHS prescription charges for each item prescribed on the same prescription form. Some items carry two charges. The same drug prescribed twice on one form in the same form carries one charge. The same medication prescribed twice on one form in a different formulation (for example, tablets and capsules) carry two charges. Patients need to pay two NHS prescription charges in the same drug is prescribed on two different prescription forms.


NHS BSA (2020). November 2020 Drug Tariff online. Available at: Accessed on 14/11/2020

I am a community pharmacist working in UK. I blog about drugs, health and pharmacy.

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