What is a private prescription?
A private prescription is a term used to describe a medication prescription which is not covered under the National Health System (NHS), although it can be written by an NHS doctor or another qualified prescriber. In this post, I will be looking at some common questions surrounding private prescriptions, including:
- obtaining private prescriptions
- expiry times
- private prescriptions cost
Private prescriptions: how to get one?
There are many ways of getting private prescriptions.
Private prescriptions from a GP
Your GP can issue a private prescription; however, in primary care settings, GP may not issue private prescription as an alternative to NHS FP10 prescription. In practice, this means that only limited items are prescribed by GPs on a private prescription (BMA, 2018). These commonly include malaria prevention medication and erectile dysfunction medication. NHS, for example, suggests a prescribing limit of 4 sildenafil tablets per month per patient, and if more is needed, patients need to get it in another way, for example, via private prescription service.
Private consultation with a doctor
- If treatment is needed with medication after a private consultation has taken place (face to face) with the prescriber, a private prescription would be issued to a patient. This is possible, for example, trough an appointment in a private hospital, clinic, or dentist.
- When a referral is made to a private clinic by the NHS, and the patient is provided with a private prescription for their treatment, patients can request the same medication to be prescribed on the NHS.
- When a private doctor advises on treatment, which requires medication, a GP may issue NHS prescription based on the recommendation if she/he agrees with the advice.
Online doctor services
- There is a growing number of “online doctor services”, which offer appointments with a doctor via different online means such as a website or a smartphone app. This usually means that patients have an actual conversation with a doctor. If a doctor decides that a medication is needed, she/he will issue a private prescription for a medication. Prescriptions are usually sent by email or available to download from the website. Patients need to take this prescription to a pharmacy in order to get a supply of the drug. In this case, the patient needs to pay to cover the cost of the drug supplied.
- Note: a private prescription which is printed at home or faxed to a pharmacy does not meet legal requirements as it is not signed in ‘indelible ink‘. Although in practice, many pharmacies accept printouts / faxed prescriptions, you may be refused supply of medication. It is also important that the issuer of private prescription contacts the pharmacy to confirm that the original prescription will be delivered to the pharmacy, for example, by post.
Online services (no contact with a doctor)
- Some medicines, such as sildenafil (Viagra), are widely available directly from most major online pharmacies. Patients are usually required to submit a health questionnaire, which is screened by a doctor who then issues a private prescription. Online services may charge a consultation fee and a fee for issuing a private prescription. Many online pharmacies may have a set price, which includes all of these fees in one price of the product. Once suitability is assessed, the customer pays for the product, with a price that includes the cost of a private prescription. Customers normally have an option of delivery of the medication or collection from a conventional pharmacy.
Private prescriptions: who can issue one?
Any prescriber approved by Human Medicines Regulation 2012 can issue a private prescription. This includes:
- a doctor;
- a dentist;
- a supplementary prescriber;
- an independent nurse prescriber; and
- an independent pharmacist prescriber.
How long does private prescription is valid for?
Private prescription expires 6 months from the issue date, unless Schedule 2, Schedule 3 or Schedule 4 controlled drug is prescribed. Private prescription for Schedule drugs 2-4 is valid for 28 days. You can read more about prescription expiry times in my separate post.
How long is a repeatable private prescription valid for?
For repeatable private prescription, first dispensing needs to be done within 6 months of the issue date, following which there is no legal time limit for dispensing, however, a pharmacist would take into consideration time between each dispensing and use professional judgement and need for the medication.
Private prescriptions can be repeated; however, this needs to be clearly defined by a prescriber. Some prescribers clearly state time-scale for the dispensing of private prescriptions and its repeats, for example, ‘please repeat 5 times within 6 months from the issue date’.
What can be prescribed on private prescriptions?
Almost any drug can be prescribed on a private prescription. However, specific classes of controlled drugs have special prescription requirements. For example, Controlled drugs Schedule 2 (for example, methylphenidate class) and 3 (for example, tramadol, gabapentin, or pregabalin) require a special private prescription form (FP10PCD) and can only be issued by some prescribers.
For other drugs, a private prescription can be written on any piece of paper. In order to be valid, a private prescription needs to meet specific legal requirements.
Private prescriptions: legal requirements
A private prescription must be written by a qualified prescriber and must include:
- Signature of the prescriber (written in indelible ink)
- Address of prescriber
- Qualification of the prescriber (e.g., their registration number)
- Name of the patient
- Address of the patient
- Age, if the patient is under 12 years of age
Additionally, if a control drug schedule 2 or 3 is prescribed:
- Form, strength, and dose of a drug prescribed
- The total quantity of the drug written in words and figures
EU private prescriptions legality
Can you dispense a prescription written by a foreign doctor?
Prescriptions from the European Economic Area (EEA) countries and Switzerland are acceptable in the UK as long as they meet all legal requirements. Additionally EU prescriptions need to have:
- full details of prescriber including a telephone and email contact and work address
- details of the medicine prescribed, name (where possible generic and brand name), form, strength, quantity and dosage instructions for prescribed medicine.
A prescription that was written in a different language can still be dispensed providing all legal requirements are met.
Visit Gov.uk website for a list of all prescribing-approved countries.
What will happen after Brexit?
In case the UK leaves the EU without a deal, UK Government advised that pharmacies should continue to dispense the European Economic Area (EEA) and Swiss prescriptions (Gov.uk, 2019).
Where can I fulfil private prescriptions?
All high street pharmacies can fulfil private prescriptions. Some online dispensing pharmacies can also process private prescriptions. This normally means you need to post your private prescription before its processed.
How much does a private prescription cost?
The price for the supply of medication on private prescription is driven by the cost of drug supplied and markup. Most pharmacies have a minimum charge for processing private prescriptions. For example, Lloyds Pharmacy charges a minimum of £5 for fulfilling a private prescription, Tesco Pharmacy just £2. Pharmacies usually charge an additional 10-20% on top of the cost of the drug. This means that you can get some common drugs at a much lower cost as compared to the NHS standard prescription fee, which is currently £9. For example, a box of Amoxicillin 500mg capsules (21 capsules) would cost around £1.5, and therefore you would be expected to pay a minimum charge, which can be as little as £2 (Tesco Pharmacy). There are plenty of commonly used drugs which are very cheap and would require a minimum payment when a private prescription is presented.
Can I get an estimate price for fulfilling private prescriptions?
The easiest and quickest way of getting the price for a private prescription is to call a pharmacy or to walk in and ask for the estimate. Alternatively, you can estimate the cost of private prescription from the price information provided by pharmaceutical wholesalers. AHH Pharmaceuticals, one of the main wholesalers of drugs in the UK, provides price information on generic medication, which is updated on a monthly basis. A generic price list is located on AHH website. All prices are subject to alterations without notice.
You can estimate the cost of private prescription by looking at trade price and multiply it by 20% mark-up price. Keep in mind some pharmacies will charge a minimum fee.
Generic vs. branded products
It is worth mentioning that in many cases, generic drugs are cheaper than the same branded version. Whenever possible prescriber should issue a private prescription with the drug being prescribed in generic form. In practice, this advice may be hard to execute. If a drug exists in both generic and branded versions, a pharmacy team will be able to supply either form as long as the prescription is written for a generic drug.
Other common questions surrounding private prescriptions:
I was issued a private prescription via online service (with/without consultation with a doctor) do I have to pay for medication supply if I take my prescription to a high street pharmacy?
Yes. It is possible for patients to use online services for a private consultation with a doctor. In some cases, patients are charged an admin fee for a private prescription. This, however, does not cover the cost of drug supply in high street pharmacy.
I am normally age exempt when I collect my NHS prescriptions. Do I still need to pay for my private prescription?
Yes. The cost of private prescriptions is not covered by any NHS exemption, including the age exemption. Patients under the age of 18 and over 60 pay for medication supply on private prescription.
Can I use my prepayment card/NHS prepayment certificate as an exemption for private prescription?
No. As above, the cost of private prescriptions is not covered by any exemption, including the NHS prepayment certificate.
Can you get private prescriptions on the NHS?
No. Cost of private prescriptions is not covered by the NHS. This means patients need to pay for the cost of medication supplied on private prescription plus any additional mark-up cost that pharmacy may have.
How long does a private prescription last?
Private prescription expires 6 months from the date it was written unless a controlled drug schedule 2-4 was prescribed. In this case, prescription expires 28 days after the date it was written.
Do private prescriptions have to be handwritten?
There is no standardised form for private prescriptions. A private prescription can be handwritten or typed. Signature of the prescribed must be handwritten in 'indelible ink' and therefore a private prescription that is printed does not meet legal requirements.
Can a GP write a private prescription?
GP can issue a private prescription, however, in primary care settings, GP may not issue private prescription as an alternative to NHS FP10 prescription for example because it is cheaper. In practice, only limited items are prescribed by GPs on a private prescription.
BMA (2018). Prescribing in general practice. Available at: https://www.bma.org.uk/advice/employment/gp-practices/service-provision/prescribing/prescribing-in-general-practice Accessed on 13/03/2019
Gov.uk (2019). Available at: https://www.gov.uk/guidance/prescriptions-issued-in-the-eea-and-switzerland-guidance-for-pharmacists Accessed on 16/08/2020