A pharmaceutical trade deal between the United Kingdom and the United States, agreed upon last December, could cost Britain's National Health Service (NHS) approximately £45 billion over the next decade and potentially lead to over 200,000 preventable deaths, according to new expert analysis.
The agreement, which aims to prevent former President Donald Trump from imposing trade tariffs, requires Britain to pay 25% more for new medicines by 2035. This is projected to increase the NHS's annual spending on medications from about 9.5% to 12% of its budget, an additional cost of roughly £3 billion per year for taxpayers.
Fresh analysis published in the British Medical Journal (BMJ) estimates that the deal will divert substantial funds from crucial frontline NHS services to new medicines. Researchers project this could amount to £44.7 billion by 2036. They further estimate that diverting money from existing services could result in 229,000 excess deaths, a figure that could rise to 291,000 if the impact extends to adult social care.
The researchers, from institutions including the University of York and the University of Liverpool, suggest the deal warrants greater public and parliamentary scrutiny. They note that the government's accommodation of industry demands, with the NHS absorbing the costs, raises questions about transparency and accountability, marking a departure from previous assurances.
"It seems essential to advocate for policy grounded in public value and social purpose, and for renewed commitment to the NHS as a public institution with equity at its core, before it is too late," the authors wrote.
Their financial estimates are based on the government's plan to double medicines spending from 0.3% to 0.6% of GDP, factoring in official economic forecasts. This could increase NHS England's yearly expenditure by £1.3 billion in 2028, escalating to £8.8 billion by 2036. The total cost over the deal's duration is estimated at £44.7 billion, a figure more substantial than the government's own projection of £1 billion annually by 2029.
The study's authors describe their estimates as conservative and argue that ministers have prioritized short-term considerations over the long-term financial implications for the NHS.
To estimate the potential excess deaths, the researchers utilized metrics that link changes in healthcare spending to patient outcomes, models reportedly used by the Department of Health and Social Care (DHSC). The predictions suggest approximately 137,000 excess deaths by 2033, comparable to the number of deaths recorded in the first two years of the COVID-19 pandemic, before rising to around 229,000 by 2036.
The study indicates that the financial strain could disproportionately affect patients with conditions such as heart and breathing problems, digestive diseases, and cancer. It also warns of potential impacts on those with brain and hormone conditions, as well as mental health difficulties.
Furthermore, the researchers highlight evidence suggesting that reductions in NHS spending tend to have a greater impact on the most deprived populations in the UK, exacerbating existing health inequalities.
Instead of increasing pharmaceutical spending, the researchers propose that the billions allocated could fund more cost-effective public health initiatives, such as obesity treatment, smoking cessation programs, exercise initiatives, and mental health care, arguing these would offer better value for money.
A spokesperson for the DHSC stated that the partnership with the US has reformed medicine pricing, enabling NHS patients to access new medicines they might otherwise have been denied, and is positioning the UK as a hub for medicine development and manufacturing. The department disputed the £45 billion figure, asserting that the deal would be funded through allocations made at the Spending Review, which secured record funding for the NHS, and that future funding would be determined at the next Spending Review.
NHS England did not provide a comment on the matter.