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The number of people issued medical exemption certificates which entitles them to free NHS prescriptions fell in 2025-26, according to the latest official data.

The NHS Business Services Authority said 436,000 certificates were issued, a 9.9 per cent decrease from 484,000 in 2024-25. The number of certificates issued increased between 2021-22 and 2024-25.

The NHSBSA said that because certificates are normally valid for five years, the reduced number in 2020-21 “may be contributing to fewer renewals in 2025-26”.

It also said there is a “strong relationship between applicant age and medical exemption certificates, with the number of certificates issued increasing as age increases”.

“This may be expected due to long-term conditions and multi-morbidity being more prevalent in older people,” the NHSBSA said.

The number of NHS Low Income Scheme certificates, which support patients with NHS costs, increased by 7.1 per cent in 2024-25 to 259,000 in 2025-26 when 162,000 HC2 certificates and 97,000 HC3 certificates were issued.

HC2 certificates provide free NHS prescriptions, dental treatment, sight tests, wigs and fabric support and help with the cost of glasses or contact lenses and the cost of travelling to receive NHS treatment.

HC3 certificates provide limited help with costs for NHS dental treatment, sight tests, wigs and fabric supports and travel to receive NHS treatment.

People aged 65 and over made up the largest proportion of those issued HC2 certificates while patients aged 20 to 24 were mostly issued HC3 certificates.

The number of hormone replacement therapy prescription prepayment certificates (HRT PPC) issued increased between 2024-25 and 2025-26, from 542,000 certificates to 572,000.

More than 90 per cent of HRT PPCs were issued to people aged 45 and over while 50 to 54-year-olds made up the highest proportion of those issued certificates at 212,000.

The number of NHS Prescription Prepayment Certificates (PPC) is also on the increase. In 2025-26, 3.2 million were issued, including 2.2 million 12-month certificates and one million three-month certificates. 

The number of 12-month certificates issued has risen every year since 2018-19 and increased by 2.3 per cent from 2024-25. The number of three-month certificates has increased each year since 2020-21, rising by 2.5 per cent from 2024-25.