See your price in 60 seconds
An NHS prescription costs £9.90 per item in England at the 2025/26 rate — the charge is reviewed each April, so check the current figure. Prescriptions are free in Scotland, Wales and Northern Ireland, and most people in England are exempt anyway: roughly nine in ten items are dispensed free of charge.
- ✓England: £9.90 per item (2025/26 rate, reviewed each April). Scotland, Wales, NI: free.
- ✓The charge is per item, not per form — and it's flat whatever the medicine really costs.
- ✓Roughly nine in ten items in England are dispensed free under an exemption.
The charge at a glance
The UK doesn't have one prescription charge — it has four systems. England charges a flat fee per item; the other three nations abolished charges years ago. The English charge is a contribution towards NHS costs, not a price: you pay the same whether the medicine costs the NHS pennies or hundreds of pounds.
| Nation | NHS prescription charge |
|---|---|
| England | £9.90 per item (2025/26 rate; reviewed each April) |
| Scotland | Free (since 2011) |
| Wales | Free (since 2007) |
| Northern Ireland | Free (since 2010) |
What "per item" actually means
The charge applies to each medicine on the prescription form, not to the form itself. One script listing three different medicines costs three charges; a larger quantity of a single medicine is still one item, one charge. That's why prescribers will sometimes issue a longer supply of a stable repeat medicine — fewer charges across the year — though prescribing durations follow clinical guidance, not the fee.
A few things carry no charge in England regardless of who you are: prescribed contraception, medication administered personally by a GP, and medicines supplied through certain hospital and clinic routes. Fit notes and NHS repeat dispensing itself are also free — the charge only attaches to the items.
It's also worth being clear what the charge isn't: it bears no relation to the medicine's real cost. The NHS medicines bill runs to many billions a year, and the charge recovers only a small fraction of it — you pay the same £9.90 for a packet that costs the NHS pence as for a drug costing it hundreds of pounds a month. That asymmetry is why the NHS route is nearly always the cheaper one for anything branded or expensive, and why the comparison with private prescribing only gets interesting for cheap generics.
Who is exempt in England
Exemptions are broad, which is how most items end up free. You don't pay the English charge if any of these applies:
- Age. Under 16, aged 16 to 18 in full-time education, or 60 and over.
- Maternity. Pregnant, or within 12 months of giving birth, with a maternity exemption certificate.
- Medical conditions. A medical exemption certificate covers listed conditions — including diabetes treated with medication, epilepsy needing continuous treatment, an underactive thyroid, cancer treatment and several others. The certificate then makes all your NHS prescriptions free, not just those for the qualifying condition.
- Low income and benefits. Income Support, income-based JSA and ESA, Pension Credit Guarantee Credit, some Universal Credit claimants within earnings limits, and the NHS Low Income Scheme (HC2 certificate).
- War pension exemptions for treatment related to an accepted disability.
The prescription is the easy bit
Paying for several items a month? Cap it
If you pay the English charge and collect more than one item a month, a prescription prepayment certificate (PPC) almost certainly saves money: you pay a fixed fee — around £32 for three months or around £114.50 for twelve at current published rates — and all your NHS prescriptions are covered, however many items you need. There's also a separate, cheaper certificate covering listed HRT medicines. Buy direct from the NHS Business Services Authority at nhsbsa.nhs.uk, which also publishes the current prices.
The quick test: at £9.90 per item, twelve charged items a year — one a month — costs more than an annual PPC. Anything beyond that is pure saving.
NHS charge vs private prescriptions
The £9.90 figure only applies to NHS prescriptions in England. A private prescription — from a private GP, a consultant, or an online prescribing service — has no flat charge at all: you pay the medicine's real market price plus the pharmacy's dispensing fee, which can come to less than £9.90 for a cheap generic or hundreds of pounds a month for a branded drug. We've broken that down separately in what private prescriptions really cost.
The two systems meet more often than people expect. See a private consultant and you'll usually leave with a private prescription; for anything ongoing, your NHS GP can often agree to take over the prescribing, which moves the medicine back to the flat charge — or to free, if you're exempt. GPs aren't obliged to take over high-cost or off-formulary drugs, so it's a question worth asking in the private consultation itself, before the repeat costs start accumulating.
Where health insurance fits in
Private health insurance doesn't change what the NHS charges you — but it changes which route you use. The virtual GP services included with most policies can see you the same day and prescribe privately, which matters when the wait for an NHS GP appointment is the real cost; our guide to GP appointments and health insurance covers how that works. Drugs supplied during covered private treatment are generally paid by the insurer, while routine repeat medication stays with you on either system. If it's the £9.90 charges themselves that add up, a health cash plan is the product that reimburses everyday costs like prescription charges, rather than full medical insurance.
Frequently asked questions
How much is an NHS prescription in England right now?
£9.90 per item at the 2025/26 rate. The charge is reviewed each April, so check nhs.uk for the current figure. It's a flat contribution per medicine, identical whether the drug costs the NHS pence or hundreds of pounds, and it only applies in England — the other UK nations charge nothing.
Why are prescriptions free in Scotland and Wales but not England?
Devolution. Health is run separately in each UK nation, and Wales (2007), Northern Ireland (2010) and Scotland (2011) each chose to abolish prescription charges. England kept its charge, offset by wide exemptions and the prepayment certificate. Where you're registered with a GP, not where you live or work, determines which system applies to your prescriptions.
Do I pay one NHS prescription charge per item or per form?
Per item. Each different medicine on the form attracts its own £9.90 charge in England, so a script with three medicines costs £29.70. Quantity doesn't matter — two months' supply of one medicine is still a single item and a single charge, which is why longer prescribing durations for stable repeats reduce your annual cost.
Who qualifies for free NHS prescriptions in England?
Under-16s, 16 to 18s in full-time education, everyone 60 and over, pregnant women and new mothers with a maternity exemption certificate, holders of medical exemption certificates for listed conditions, people on qualifying benefits or the NHS Low Income Scheme, and some war pensioners. Between them, these exemptions cover roughly nine in ten items dispensed in England.
Are prescriptions free once you turn 60 in England?
Yes — 60 is currently the age at which NHS prescription charges stop in England, with no certificate needed; the pharmacy simply confirms your date of birth. Proposals have been floated over the years to align the threshold with State Pension age, but no change has been made, so check the current rules if you're close to 60.
Do you pay for NHS prescriptions when pregnant?
No. Pregnancy and the 12 months after giving birth qualify you for free NHS prescriptions in England through a maternity exemption certificate — your midwife or GP handles the application. The exemption covers all your NHS prescriptions during that window, not just pregnancy-related medicines. Scotland, Wales and Northern Ireland are free for everyone regardless.
Can I get free NHS prescriptions on Universal Credit?
Sometimes. Universal Credit isn't an automatic exemption — you qualify if your earnings in your last assessment period were under the published threshold, which differs depending on whether your claim includes children or limited capability for work. Check the current criteria on nhsbsa.nhs.uk before ticking the exemption box, as wrong claims can attract penalty charges.
Is the NHS prescription charge the same whatever the medicine costs?
Yes — that's the point of it. The English charge is a flat contribution per item, completely disconnected from the medicine's real cost to the NHS. You pay £9.90 for a drug that costs pennies and £9.90 for one that costs the NHS hundreds of pounds a month. Private prescriptions work the opposite way: you pay the market price.
When does the NHS prescription charge go up?
Reviews happen annually, with any change usually taking effect on 1 April. The charge has typically risen by small increments, though it has also been frozen in some years. The £9.90 figure is the 2025/26 rate; nhs.uk always shows the current charge, and prepayment certificate prices are reviewed on the same cycle.
Is prescribed contraception free in England?
Yes. Contraception prescribed on the NHS carries no charge in England, regardless of your age, income or exemption status — it sits outside the £9.90 system entirely. Since 2023 many pharmacies can also supply oral contraception directly under NHS arrangements without a GP appointment. Other medicines on the same prescription form are charged normally.