Overview
- A BMJ analysis published 1–2 July 2026 projects roughly £44.7–45bn in extra NHS drug spending by 2036 if the deal’s costs are not met with new funding.
- The study estimates about 229,000 excess preventable deaths in England by 2036 from resources shifted away from other NHS care and 291,000 deaths if adult social care effects are included.
- Under the December 2025 agreement the government secured zero US tariffs on UK pharma for three years in return for committing to raise UK spending on new branded medicines from about 0.3% of GDP to at least 0.6% by 2036.
- Policy changes linked to the deal include a lower industry rebate rate under VPAG (cut from 23% to 14.5%) and a higher NICE cost‑effectiveness threshold, both of which are likely to raise the prices the NHS pays for medicines unless extra funds are provided.
- The report has prompted calls for the Department of Health and Social Care to publish its withheld impact assessment, spurred political and campaign group scrutiny, and sharpened questions about who will pay for higher drug bills given the NHS’s fixed budget and the UK’s status as a net importer of medicines.