US-UK drug trade could cause 229,000 excess deaths in UK, analysis suggests | NHS

The NHS will have to divert £45 billion from essential services to pay for new drugs under the terms of the UK-US trade deal agreed in December last year, leading to more than 200,000 avoidable patient deaths, an analysis has found.

Ministers have defended the deal as a way to help UK exports of medicines to the US avoid tariffs and give patients in the UK access to potentially life-extending medicines they would otherwise be denied.

But they have been accused of caving in to pressure from Donald Trump to US demands to spend billions more pounds a year on drugs supplied to the NHS. The potentially devastating impact on NHS care is raising growing alarm even among health experts.

Now analysis published in the British Medical Journal has revealed for the first time the transaction costs to the NHS and the expected devastating impact of health service cuts on the UK population.

A total of £44.7 billion of NHS cash will be diverted from the health service by 2036 to pay more for new drugs under a trade deal unless additional funding is provided to cover the additional costs, analysis suggests.

Reductions in NHS spending on services will have a negative impact on the country’s public health, leading to 229,000 excess deaths by 2036. The estimated number of avoidable deaths is higher than the number that occurred during the Covid-19 pandemic between March 2020 and June 2022 (137,000).

Including indirect effects on adult social care, the number of excess deaths would rise to 291,000, said the report by the University of York, the University of Liverpool and New Zealand’s Christchurch Hospital. Most preventable deaths occur in people with heart, respiratory, gastrointestinal diseases or cancer.

When the agreement was reached last December, ministers hailed the deal as a “landmark” that would “protect access to medicines and promote vital investment for UK patients and businesses”.

The UK has agreed to pay 25% more for new drugs over the next 10 years. The deal will also see the UK’s health service, which currently spends £14.4 billion a year on innovative treatments, double the proportion of GDP it allocates to purchasing such products from 0.3% to 0.6% over the next decade.

Ministers and pharmaceutical industry officials said the deal was good news because it would allow British-made drugs sold in the United States to avoid tariffs of up to 100% that President Trump had threatened to impose on some medicines imported into the United States.

But lawmakers and campaign groups have voiced skepticism. The deal would lead to the axing of the NHS “to appease Donald Trump and Big Pharma’s demands for high drug prices”, UK-based campaign group Global Justice Now previously warned.

Labor lawmakers and several opposition lawmakers have also called on the government to publish its own confidential impact assessment of the trade deal it signed with the Trump administration in December.

The government said the deal would only result in additional costs of £1 billion between 2025-26 and 2028-29. It acknowledged that costs would increase after 2028-29 but did not provide estimates for this.

In February, Science Secretary Patrick Vallance said the costs would be borne by the Department of Health and Social Care, which funds England’s NHS, rather than the Treasury.

Annual costs for the NHS will soar to £8.8 billion by 2036, with total bills reaching £44.7 billion by the end of that year, according to BMJ analysis.

Sir Ciarán Devane of the NHS Alliance, which represents the health systems in England, Wales and Northern Ireland, said the analysis raised “serious questions” about whether the trade deal was worth it for patients or the NHS.

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“If billions of pounds are diverted from frontline care to cover higher medicine costs, the consequences for prevention, community services and treatment of long-term conditions could be profound. The government must urgently publish a full impact assessment and ensure that there is appropriate scrutiny if this deal could have such far-reaching impacts on population health.”

Liberal Democrat health spokeswoman Helen Morgan called the analysis “alarming” and urged the government to urgently publish its own impact review of the UK-US deal.

Morgan said it was “madness” that billions of pounds of NHS money were being spent on appeasing Donald Trump. “This is a complete insult to the patients suffering and dying on hospital trolleys and waiting months for treatment. We cannot stand by while our NHS is co-opted by a foreign regime. We must defend the NHS with everything we have and stand firm against the bullies in the White House.”

Tim Bierley, campaigner at Global Justice Now, said: “Billions of dollars that could be spent on recruiting NHS staff, reducing GP waiting times or improving hospital care will be siphoned off by pharmaceutical giants. Research shows that if funds are diverted from other vital parts of the NHS to pay for these transactions, this will lead to hundreds of thousands of deaths.

“Unfortunately, this backroom deal received no scrutiny in Parliament before being rushed through and the Government has refused to say what impact this will have on the NHS. The next Prime Minister must change course, stand up for the NHS and resolve the mess left by his predecessors.”

Diarmaid McDonald, executive director of patient campaign group Just Treatment, said: “These figures will shock people to their core. Tens of billions of pounds are being taken from the NHS budget and put into the back pockets of the pharmaceutical industry, putting hundreds of thousands of lives at risk.”

“Across the country, our parents, grandparents and loved ones are dying needlessly to inflate the profits of pharmaceutical companies and please Donald Trump. This is a national scandal.”

A Department of Health and Social Care spokesperson said: “Through our partnership with the US, we are reforming medicines pricing to ensure NHS patients have access to life-changing new medicines they had previously been denied. We are also making the UK one of the best places in the world to develop, launch and manufacture new medicines.”

“The figure of £45 billion is not accepted by the department. The deal will be funded by allocations from the spending review, which secured record funding for the NHS. Future funding will be settled in the next spending review.”

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