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BMJ Analysis Says UKUS Drug Deal Could Force NHS to Find £45bn and Cause Hundreds of Thousands of Deaths

Researchers say higher medicine prices and changes to NHS cost rules risk diverting funds from care and campaigners are demanding the government's impact assessment be published

Overview

  • A Liverpool University analysis published in the BMJ this week estimated the UKUS drug‑pricing agreement would cost the NHS about £45 billion by 2036 and lead to roughly 229,000 additional preventable deaths, rising to 291,000 when effects on adult social care are included.
  • The government has already changed policy to allow higher drug spending by instructing NICE in April 2026 to raise its cost‑effectiveness threshold and by committing to double spending on new medicines to at least 0.6% of GDP by 2036.
  • Researchers say the threshold change and a reduced industry rebate will mainly raise the prices the NHS pays for drugs already entering the service instead of substantially increasing the number of new medicines approved.
  • Reports say President Trump threatened tariffs during trade talks and several drug companies signalled or paused UK investment, and campaign groups plus the study authors are demanding the unpublished government impact assessment and warning of legal challenge.
  • If NHS money is shifted to pay higher drug bills, the paper warns funds will be taken from staff, scans, beds and other treatments, which the authors link to the projected rise in deaths and urge parliamentary scrutiny of the deal.