The United Kingdom’s drug pricing agreement with former President Donald Trump is projected to result in more fatalities than the Covid-19 outbreak if National Health Service (NHS) resources are redirected to cover the costs, according to a recent study.
An evaluation of the health implications of the US trade pact indicated a potential increase of 229,000 deaths by 2036 if funds are shifted from other NHS services towards procuring medications. The study, conducted by experts from Liverpool University, highlighted that around £45 billion in NHS funding would be required by 2036 to accommodate the elevated prices demanded by US pharmaceutical companies. Concerns have been raised that prioritizing this deal to satisfy President Trump’s demands could result in reduced financial resources for NHS personnel and essential equipment.
President Trump had previously threatened imposing significant tariffs on drug imports from UK-based companies unless the NHS agreed to purchase pricier medications from American firms. The NHS, known for its collective bargaining power, has historically secured more cost-effective pricing compared to private hospitals in the US.
The recent analysis, published in the British Medical Journal, warned that without additional funding to bridge the gap, there could be a substantial increase of preventable deaths reaching 229,000 by 2036. When factoring in the indirect impact on adult social care, the estimated excess deaths could rise to 291,000, surpassing the 137,000 Covid-19-related deaths recorded between March 2020 and June 2022.
Andrew Hill, author from the Department of Pharmacology at Liverpool University, emphasized, “In publicly funded systems operating within finite budgets, heightened expenditures in one area inevitably limit opportunities for investment elsewhere. This underscores the critical nature of decisions regarding medicine pricing and the subsequent allocation of healthcare resources, often referred to as opportunity cost in health economics.”
While novel treatments for conditions like cancer may extend patients’ lives, they come at a substantial cost exceeding £1 million over the treatment period. Recent adjustments by the National Institute for Health and Care Excellence (NICE) have expanded the threshold for cost-effectiveness of new medicines, indicating a shift towards allocating more resources to pharmaceutical advancements. Under the terms of the agreement, the government committed to doubling spending on new medications from 0.3% to a minimum of 0.6% of the gross domestic product (GDP) by 2036.
Despite the potential benefits, critics raise concerns that some drugs previously deemed not cost-effective for the NHS may now be prescribed under the agreement, potentially diminishing the incentive for pharmaceutical companies to lower prices. Cutting-edge treatments, such as immunotherapy for cancer costing hundreds of thousands per dose, are expected to receive approval, but without sufficient funding to cover these expenses, there may be a strain on NHS staffing and critical infrastructure.
NICE currently greenlights approximately 90% of evaluated medicines, with estimates suggesting that the agreement may lead to only a modest increase of two to five additional approved drugs annually. This indicates a likelihood of the deal primarily affecting the pricing of existing NHS-prescribed medications rather than significantly broadening the range of available treatments.
The government’s acceptance of the deal followed warnings from several pharmaceutical corporations threatening to withdraw investments from the UK amid Trump’s trade threats unless higher payments were agreed upon. Last year, AstraZeneca, Lilly, and Merck halted £1.3 billion in investments in Britain, with Merck abandoning a £900 million research and development center project initiated in the country.
While the government conducted an impact evaluation on the broader repercussions of the trade deal, this report has not been disclosed publicly. Calls have been made by the authors for comprehensive transparency on the details of the deal and its associated impact assessment.
The study’s conclusion emphasized the need for scrutiny and accountability, stating, “The government’s willingness to yield to industry pressures while the NHS bears the resulting costs raises significant transparency and accountability concerns.”
Meanwhile, UK activists are contemplating legal action against the government over the agreement. Just Treatment, a patient advocacy group, and Global Justice Now, a social justice organization, voiced opposition to the deal in a letter to Health Secretary James Murray last month.
Highlighting the potential risks, Tim Bierley, a campaigner at Global Justice Now, expressed, “The Trump medicines deal poses a substantial threat to both our health and economy. The billions that could be allocated to enhance NHS services, reduce GP waiting times, or upgrade hospital care are at risk of being diverted to pharmaceutical giants, compromising public health.”
“If funds