Hundreds of thousands of women experiencing menopause symptoms to get cheaper HRT

Around 400,000 women across England will get better access to menopause support – saving hundreds of pounds and making treatment more accessible.

  • Women in England will be able to access cheaper hormone replacement therapy (HRT) for menopause through a new prescription prepayment certificate (PPC)
  • To be rolled out from 1 April 2023, the certificate will help around 400,000 women save hundreds of pounds a year, reducing their HRT costs to less than £20 a year
  • Better access to HRT will improve the lives of millions of women in England who suffer from negative symptoms of the menopause

From 1 April 2023, women prescribed HRT – the main treatment for menopause symptoms – will have access to a new scheme enabling access to a year’s worth of menopause prescription items for the cost of 2 single prescription charges (currently £18.70).

As part of commitments to reduce the cost of HRT for menopausal women, the PPC will be valid for 12 months. It can be used against a list of HRT prescription items, and a patient can use this against an unlimited number of HRT items, such as patches, tablets and topical preparations. There will be no limit to how many times the certificate can be used while it is valid.

Reducing the cost of HRT is just one of the steps being taken by the government to improve access to HRT, alongside continuing work with suppliers to encourage and support them to boost supply to meet growing demand.

The introduction of the certificate delivers one of our year 1 priorities for the Women’s Health Strategy for England. Published last summer, the strategy sets out an ambitious new agenda for improving the health and wellbeing of women and girls and to improve how the health and care system listens to women. Menopause was announced as a priority area within the strategy.

Health and Social Care Secretary Steve Barclay said:

This new certificate will make HRT more accessible than ever before – helping around 400,000 women save hundreds of pounds a year.

This is another step in our drive to improve support for millions of women experiencing the menopause, delivering on our Women’s Health Strategy.

Minister for Women, Maria Caufield, said:

Around three-quarters of women will experience menopause symptoms, with a quarter experiencing severe symptoms – which can seriously impact their quality of life.

Reducing the cost of HRT is a huge moment for improving women’s health in this country, and I am proud to be announcing this momentous step forward.

In our Women’s Health Strategy, we made menopause a top priority. By making HRT more accessible, we’re delivering on our commitment to women.

Women’s Health Ambassador, Dame Lesley Regan, said:

The menopause is an inevitable stage in a woman’s life course. As a gynaecologist, I’ve witnessed first-hand the symptoms that women experience, which can have debilitating impacts on their daily lives.

Making HRT more affordable will have a hugely beneficial impact on the lives of so many women. This prepayment certificate is a major step forward in prioritising the health and wellbeing of women.

Around 15% of women aged 45 to 64 in England are currently prescribed HRT, which has increased rapidly in the last 2 years from around 11% and continues to increase.

The government has accepted the recommendations of the HRT Taskforce, including encouraging and supporting manufacturers to boost supply to meet growing demand and continuing to issue serious shortage protocols (SSPs) when needed to even out distribution. This involved allowing alternative products to be dispensed when necessary, and reducing the need for the patient to return to their GP.

The department engages with suppliers on a weekly basis, closely monitors the supply of HRT, and regularly meets with individual suppliers, including hosting quarterly roundtables with industry to ensure a continuous supply of HRT.

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. When collecting HRT products, patients will be able to simply show the digital or paper copy HRT PPC to the pharmacist and complete the exemption declaration on the NHS prescription form.

Dr Ranee Thakar, President of the Royal College of Obstetricians and Gynaecologists, said:

We know that cost can be one of the barriers that women face in accessing treatment to manage their symptoms during menopause, and the introduction of HRT PPCs is a positive step to improve access to HRT. This announcement is an important first step, and we hope that more will be done to address the challenges and inequalities faced in accessing menopause care and treatment.

Dr Janet Barter, President of the Faculty of Sexual and Reproductive Healthcare, said:

We welcome the introduction of HRT PPCs by the Department of Health and Social Care. This is a big step towards improving women’s access to menopause treatment in England and reducing inequalities in access to this essential healthcare. Improved access to HRT will improve the lives of millions of women, allowing them to easily take control of their own menopause.

Janet Lindsay, CEO of Wellbeing of Women, said:

HRT is a first line treatment for women who may need help with managing menopause symptoms which can be debilitating. Improving access to HRT, by reducing the prescription costs, is absolutely the right thing to do and will help to empower women during this life stage.

The HRT PPC is in addition to the existing help with prescription charges, including the 3 and 12 month PPCs.

For people who need multiple medicines, the existing PPCs may remain a more cost effective method of paying for prescriptions.

HRT items in scope for the HRT-only PPC (as of 21 February 2023)

Product name Ingredient
Bedol (Estradiol 2mg)
Bijuve/Bijuva (Estradiol 1mg; micronised progesterone 100mg)
Blissel (Estriol 50mcg)
Climanor (Medroxyprogesterone 5mg)
Clinorette (Estradiol 2mg; norethisterone 1mg)
Elleste Duet (Estradiol 1mg and 2mg; norethisterone 1mg)
Elleste Duet Conti (Estradiol 2mg; norethisterone 1mg)
Elleste Solo (Estradiol 1mg and 2 mg)
Estraderm MX (Estradiol 25mcg, 50mcg, 75mcg and 100mcg)
Estradot (Estradiol 25mcg, 37.5mcg, 50mcg, 75mcg and 100mcg)
Estring (90-day preparation) (Estradiol 7.5mcg/24 hours)
Estriol (Estriol 0.01%)
Ethinylestradiol 10mcg (Ethinylestradiol 10mcg)
Evorel (Estradiol 25mcg, 50mcg, 75mcg and 100mcg)
Evorel Conti (Estradiol 50mcg; norethisterone 170mcg)
Evorel Sequi (Estradiol 50mcg; norethisterone 170mcg)
Femoston Estradiol 1mg and 2mg; dydrogesterone 10mg)
Femoston Conti (Estradiol 500mcg and 1mg; dydrogesterone 2.5mg and 5mg)
Femseven (Estradiol 50mcg, 75mcg)
Femseven Conti (Estradiol 50mcg; levonorgestrel 7mcg)
FemSeven Sequi (Estradiol 50mcg; levonorgestrel 10mcg)
Gina (Estradiol 10mcg)
Imvaggis (Estriol 30mcg)
Indivina (Estradiol 1mg and 2mg; medroxyprogesterone 2.5mg and 5mg)
Kliofem (Estradiol 2mg; norethisterone 1mg)
Kliovance (Estradiol 1mg; norethisterone 500mcg)
Lenzetto (Estradiol 1.53mg)
Livial (Tibolone 2.5mg)
Mirena (Levonorgestrel 20mcg/24 hours)
Novofem (Estradiol 1mg; norethisterone 1mg)
Oestrogel/dose (Estradiol 0.06%)
Ovestin (Estriol 1mg)
Premarin (Conjugated oestrogen 300mcg, 625mcg and 1.25mg)
Premique low dose (Conjugated oestrogen 300mcg; medroxyprogesterone 1.5mg)
Progynova (Estradiol 1mg and 2mg)
Progynova TS (Estradiol 50mcg and 100mcg)
Sandrena (Estradiol 500mcg and 1mg)
Tridestra (Estradiol 2mg; medroxyprogesterone 20mg)
Trisequens (Estradiol 2mg/2mg/1mg; norethisterone 1mg)
Utrogestan (Micronised progesterone 100mg and 200mg)
Vagifem (Estradiol 10mcg)
Vagirux (Estradiol 10mcg)
Zumenon (Estradiol 1mg and 2mg)