The written prescription fee cap is real, and it is the only price control the CMA imposed. The figures being quoted are not the figures that will bind you: in the draft Order they appear in square brackets, to be uplifted for inflation before the Order is made and then indexed every year.
Article · 3 August 2026
If you have written £21 into a business plan as the new maximum you can charge for a written prescription, take it back out. That figure comes from the CMA's final report of 24 March 2026. In the draft Order published on 21 July 2026 it appears in square brackets, along with an instruction to adjust it for inflation between the date of the final report and the latest monthly CPI figure available before the Order is made — and then to index it annually. The cap is coming. The number is not yet a number.
That matters more than a pedant's footnote, because the cap is the single remedy in the whole package with a direct, arithmetic effect on a revenue line. Getting the mechanism right and the figure provisional is the only defensible way to model it.
Paragraph 84 of the final report sets a maximum price for providing a written prescription for the first medication prescribed within a consultation at £21 including VAT, with any additional prescription within the same consultation capped at £12.50 per medicine including VAT. The same paragraph states that the caps will be adjusted annually for inflation.
The draft Order then defines two terms — the Initial Primary Prescription Fee Cap and the Initial Additional Prescription Fee Cap — and puts both amounts inside square brackets, with the bracketed text saying the figure will be adjusted for inflation between the date of the final decision report and the latest monthly CPI figure available before the Order is made. Square brackets in a draft statutory instrument are the drafter's way of saying "a number goes here and we do not know it yet".
So there are two uplifts, not one. A CPI adjustment from 24 March 2026 to whenever the Order is made, and then annual indexation after that. Anyone quoting £21 as the legal maximum is quoting a figure that will have moved before it ever binds anyone.
The cap is not aimed at a market that is already clustered around it. Paragraph 85 of the final report records current written prescription charges running from around £10 at the lowest, with significant numbers of first opinion practices charging over £30, and some significantly in excess of that.
That spread is the whole point of the remedy. A practice at £10 is unaffected. A practice at £34 is looking at a reduction of roughly a third on that line, before any inflation uplift is applied to the cap. Which end of the range you sit at determines whether this is an administrative change or a revenue event, and it is worth establishing before anything else.
Draft Article 18 applies the caps to veterinary businesses providing first opinion services, including out-of-hours premises. There is no carve-out for a single-site practice: a sole-practitioner first opinion practice is a veterinary business, and a small one.
On timing, this is the remedy where the widely repeated "smaller businesses get three months longer" line breaks down. Article 3(1) gives a Large Veterinary Business — 15 or more first opinion practices and/or out-of-hours centres — six months from the Order, and a Small Veterinary Business twelve months. So six months longer, not three. For a large group the cap therefore bites before written estimates and itemised bills, which sit at nine months. For an independent, everything difficult arrives together at twelve.
Both figures are expressed including VAT, and most practice management systems hold prices net. On the final-report figures that means a net-of-VAT equivalent of £17.50 for the first medicine and £10.42 for each additional one, at the 20% standard rate.
Check the arithmetic rather than take it on trust: £21.00 divided by 1.2 is £17.50, and £12.50 divided by 1.2 is £10.4166, which rounds to £10.42. A practice that sets its system to £21.00 net will be charging £25.20 gross and will be over the cap by £4.20 on every prescription. That is a configuration error, not a pricing decision, and it is the kind that repeats a few thousand times before anyone notices.
One caveat on the VAT itself. There is no relief in the VAT medical exemption for veterinary work — that exemption covers human health professionals — so the standard 20% rate applies by operation of law rather than because any gov.uk page says so in terms. The gov.uk page listing VAT rates on different goods and services has no veterinary entry at all.
Take a two-site independent currently charging £28 for a written prescription and issuing 40 of them a month. These figures are illustrative and the arithmetic is worth following.
The fee line, though, is the smaller half of the story. Articles 14 to 16 require practices to make pet owners aware of their right to a written prescription, to provide one as hard copy by the end of the consultation or digitally within 48 hours, and to hand over a standard flyer for ongoing medication. Volumes will go up. So the fee line may well hold on volume even as the unit price falls — and the dispensing line behind it is what moves.
The CMA's finding there is specific: pet owners could save £200 to £300 a year on average by buying commonly prescribed medicines from an online pharmacy rather than from a first opinion practice, with online prices 50% to 60% below practice prices for some products. Continuing the illustration, if 20 clients a month move their repeat medication elsewhere, that is 240 clients a year. At the midpoint of the CMA's range, 240 x £250 = £60,000 a year of price difference leaving the practice. And because £250 is the owner's saving rather than their total spend, the revenue at risk is larger than £60,000, not smaller.
Set the two together and the priority inverts. £3,360 off the fee line is an irritation. A five-figure shift in dispensing volume is a business model question, and it is the one worth modelling first.
Worth stating clearly, because the assumption runs the other way. The CMA decided against a general price control, and the written prescription fee is the sole exception. It also decided against a profit cap, on the basis that capping the profitability of businesses would be disproportionate. No practice is going to be told what to charge for a consultation, a vaccination or a dental scale. What it will be told is that the price has to be published, in weight bands, where anyone can compare it.
Safe: there will be a cap on what a practice may charge for a written prescription; the CMA's final report set it at £21 including VAT for the first medicine in a consultation and £12.50 for each additional one; those figures will be uplifted for inflation before the Order is made and indexed annually thereafter. Not safe: quoting either figure as your future price, or as the law. The Order has not been made, and the binding figure is not yet known.
Model a range, not a point. Take your actual prescription volume and your actual current charge, then run the fee line at the final-report figure and a little above it — the answer will be stable enough to plan on. Then, separately and with more care, model the dispensing side: which products, at what volume, with what price gap against an online pharmacy. That is where the money is.
What to leave alone is the temptation to raise the fee now, ahead of a cap. A practice that moves from £28 to £34 this year will have further to fall and will have done it in a market where ownership, prices and pet care plan components are all about to become publicly comparable.
The prescription fee modeller runs the fee line on your own volumes and charges. The wider pricing question — weight bands, plan components, what a published list does to your margin — is in the practice pricing guide, and the sequencing of the whole package is in our CMA remedies guide. If you want the modelling done on your figures rather than illustrative ones, that is CMA compliance and pricing. The reason no date appears anywhere above is set out in the Order has not been made yet.
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There will be a cap, but £21 is not yet its value. The CMA's final report of 24 March 2026 set a maximum of £21 including VAT for the first medication prescribed in a consultation and £12.50 including VAT for each additional medicine. In the draft Order published on 21 July 2026 both figures appear in square brackets, with the bracketed text stating they will be adjusted for inflation between the date of the final report and the latest monthly CPI figure available before the Order is made, then indexed annually. So the mechanism is settled and the number is provisional.
Yes. Draft Article 18 applies the caps to veterinary businesses providing first opinion services, including out-of-hours premises, and there is no exemption for size. A single-site or sole-practitioner first opinion practice is a veterinary business for the purposes of the Order and is a Small Veterinary Business, meaning fewer than 15 first opinion practices and out-of-hours centres. What size changes is the lead-in. On this particular remedy a large business has six months from the Order and a small business has twelve, which is a six-month gap rather than the three months quoted for most remedies.
It means the figure you enter is not the figure in the report, if your system holds prices net of VAT. On the final-report numbers and the 20% standard rate, £21 including VAT is £17.50 net and £12.50 including VAT is £10.42 net, because £21 divided by 1.2 is £17.50 and £12.50 divided by 1.2 is £10.4166. A practice that keys £21.00 into a net price field will charge £25.20 gross and exceed the cap by £4.20 every time. Worth building the conversion into whatever configuration change you make rather than doing it in your head at the till.
Almost certainly not, for most practices. The fee itself is a modest line: forty prescriptions a month at £28 is £13,440 a year, and the final-report cap would take about £3,360 off it. The larger effect sits behind it. Articles 14 to 16 require practices to make owners aware of their right to a written prescription and to provide one promptly, so volumes rise. The CMA found owners could save £200 to £300 a year buying commonly prescribed medicines online, with some online prices 50% to 60% below practice prices. The dispensing line is where the exposure is.
No. The written prescription fee is the only price control in the package. The final report records a decision against a general price control, and a separate decision against a profit cap on the basis that capping the profitability of businesses would be disproportionate. So nothing tells a practice what to charge for a consultation, a vaccination, a diagnostic test or an operation. What the remedies do instead is force the prices to be published in a comparable form, by weight band, alongside ownership information and the component prices inside pet care plans. Transparency, not price setting, is the mechanism.
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