Veterinary Prescription Fee Caps Under the CMA Reforms

What you will be able to charge for a written prescription

Order made; the cap applies from 2027. The CMA made the Veterinary Services Market Investigation Order 2026 on 22 September 2026, and it came into force the next day. Under Article 3 of the Order the prescription fee cap has a compliance date of 22 March 2027 for larger businesses (15 or more first-opinion practices and/or out-of-hours centres) and 22 September 2027 for smaller ones, and practices must comply from the next working day after that date.

The CMA Order caps what a practice can charge a pet owner for a written prescription. The Order sets the maximum at £21.40 for the first medicine prescribed and £12.70 for each additional medicine prescribed at the same time, both including VAT. The caps exist so that a client who wants to buy medication elsewhere, often more cheaply online, is not deterred by a prescription charge set high enough to wipe out the saving. The fee only matters because of the underlying entitlement — the right to a written prescription — which the same Order puts on a formal footing.

It is one part of the wider CMA veterinary regulations package. For practices, this is both a transparency obligation and a pricing change: the prescription fee has to be disclosed and it has to sit within the caps. This guide covers the exact limits, how they interact with dispensing, and the practical steps to be compliant.

The caps in detail

The Order defines both figures directly. It states that "‘Initial Primary Prescription Fee Cap’ means £21.40 inclusive of VAT." and that "‘Initial Additional Prescription Fee Cap’ means £12.70 inclusive of VAT."

Article 18 applies them at each first-opinion practice (FOP) and out-of-hours centre. The primary cap covers the first medicine prescribed, whether within a consultation or outside one. The additional cap covers each further medicine prescribed in the same consultation, or alongside a first medicine prescribed outside a consultation. ("FOP" is the CMA's term for a first-opinion practice — a normal vet practice providing the initial consultation, as opposed to a referral centre.)

Why you may have seen £21 and £12.50. Those were the figures in the CMA's March 2026 Final Report, and the CMA's earlier guidance page for practices used them too. The Order raises them for inflation. Its Explanatory Note says the caps "have been adjusted for inflation in the period from the date of the Final Report in March 2026 and August 2026 based on CPI and rounded to the nearest 10 pence." The Order is the legally binding text, so £21.40 and £12.70 are the figures that count. The CMA's current guide for small veterinary businesses now gives the same figures: "The maximum fee for providing a written prescription is £21.40 for the primary prescription", and up to £12.70 for each additional medicine.

A worked example makes the structure clear. A pet on three new medicines from one consultation:

• First medicine (primary cap): up to £21.40
• Second medicine (additional cap): up to £12.70
• Third medicine (additional cap): up to £12.70
• Maximum prescription fee total: £46.80

These are ceilings, not set prices. A practice can charge less, or nothing, for a written prescription, but not more than the cap. The Explanatory Note adds that no extra fee can be charged on top, "for example, additional administration charges for preparing or transmitting a Written Prescription".

The caps will move each year. £21.40 and £12.70 apply until 31 March 2028. From 1 April 2028 the Order uprates both caps each year by CPI, rounded to the nearest 10 pence, and the CMA publishes the new figures on its website by 14 February each year. Build the fee into your billing system as a value you can update, not a fixed number.

When this starts to apply to your practice

The fee cap is the odd one out in the Order's medicines package. The rest of that group has compliance dates of 22 June 2027 for larger businesses and 22 September 2027 for smaller ones. The cap starts three months earlier for larger businesses. The Order's Article 3 table sets it as:

Your practice	Order compliance date (Article 3)
15 or more FOPs and/or out-of-hours centres ("Large Veterinary Business")	22 March 2027
Fewer than 15 FOPs and/or out-of-hours centres ("Small Veterinary Business")	22 September 2027

Practices must comply from the next working day after the date shown. The six-month gap between the two dates is the widest in the package, and it has a commercial edge worth seeing coming. From March 2027 the large groups will be advertising capped prescription fees while a smaller independent practice still has six months of its own runway. If your current prescription charge sits well above £21.40, that is when it becomes visible by comparison, well before your own deadline.

How the caps interact with dispensing

The caps apply to the fee for writing a prescription so the client can buy the medicine elsewhere. They do not set the price of medicines you dispense in-house. But the reforms make the choice transparent: clients have to be told they can request a written prescription rather than buy from the practice, and the prescription fee has to be visible.

The Order also closes an obvious workaround. Article 18(2) requires policies and procedures so that there is no difference between how long a medication is prescribed for when you supply it and when it goes on a written prescription for dispensing elsewhere. Controlled drugs are excluded from that duty.

The commercial implication is worth being honest about internally. Dispensing income has historically been a meaningful margin for practices, and a low, transparent prescription fee will make it easier for clients to take a prescription and buy online. The reforms are designed to do exactly that. Plan for the change rather than being surprised by it. The runway is long enough to model the revenue impact properly rather than absorb it as a shock.

What practices need to do

1. Model the change before you have to make it. Work out what your current prescription fee earns and what capping it at £21.40/£12.70 would cost, so the decision on when to move is a commercial one rather than a deadline scramble. You are free to adopt the caps before they apply to you.
2. Show the fee on your price list. "Prescription fee" and "Prescription fee for additional items prescribed at the same time as another medication" are both items on the Order's Schedule 1 price list. The price-list display rules cover where that list has to appear.
3. Tell clients about written prescriptions. Front-of-house and clinical staff should make clear that a written prescription is available on request, and what it costs.
4. Update your billing system. Configure the prescription fee as a capped line so it cannot be overcharged at the point of sale, and so the cap can be updated each April from 2028.
5. Document the process. Fold prescription transparency into your SOP framework so the rule survives staff turnover.

Common gaps to close

• Working to the old figures. A cap set at £21 and £12.50 is not wrong in the sense of overcharging, but a practice advertising "£21, the CMA maximum" is quoting the Final Report, not the Order.
• Prescription fee buried on the invoice. The fee has to be visible up front on the price list, not revealed only when the client is billed.
• Fee set above the cap. Any prescription charge over £21.40 for the first medicine, or £12.70 for each additional one, is non-compliant once your compliance date has passed.
• Clients not told they can request a prescription. Transparency about the option is part of the remedy, not just the fee level.
• Caps applied per item instead of per consultation. The primary cap covers the first medicine in a consultation. Each further medicine in that same consultation is capped at £12.70, not £21.40.

How this fits the wider CMA package

The prescription fee caps are one remedy among several — published price lists, written estimates, ownership disclosure, and complaints handling all sit in the same Order. The detail on the estimate threshold is in the CMA written estimate £500 rule, and sequencing the whole package across the staggered deadlines is what the CMA preparation timeline handles. The CMA compliance self-assessment tool flags which remedies your practice still has open, and treating them as streams within your clinical governance framework keeps them current after the initial push.

---

Reviewed 26 October 2026. The CMA made the Veterinary Services Market Investigation Order 2026 on 22 September 2026 and it came into force on 23 September 2026. The fee caps, the 15-site size boundary and the compliance dates above are taken from the Order itself, not from the draft consulted on in July and August 2026. The CMA's guides for small and large veterinary businesses, published on 13 October 2026, give the same £21.40 and £12.70 caps and the same compliance dates. This is general compliance information, not legal advice. Verify the current position against the Order and its Explanatory Note and consult your defence body for practice-specific advice.