229,000 more deaths: is this the cost of the drug trade in the US and UK? | health news

A study published in the British Medical Journal (BMJ) found that the UK-US trade in medicines could lead to 229,000 excess deaths, diverting billions of pounds from the UK’s National Health Service (NHS).

Last December, the UK and the US signed a pharmaceutical trade agreement, under which the US government agreed not to impose tariffs on British pharmaceutical and medical technology exports for the next three years.

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In return, the UK government pledged to increase NHS spending on US new drugs from 0.3% in 2026 to at least 0.6% of gross domestic product (GDP) by 2036. This means that overall spending on medicines will need to increase from 10% to 12% of the NHS budget.

British politicians defended the deal in April, with Science Secretary Patrick Vallance saying it would give patients across the NHS access to “life-changing new drugs they had previously been denied”.

“Not only that, but we will further develop the UK’s life sciences sector as the first country in the world to benefit from a 0% pharmaceutical tariff on the US,” Mr Vallance claimed.

But research published in the BMJ found that a commitment to spend significantly more on new branded medicines over the next decade without increasing NHS funding would “impact directly on population health by incurring significant opportunity costs elsewhere”.

Samuel Cross, professor of pharmacology and therapeutics at the University of Liverpool, who co-authored the report, said: “This agreement benefits pharmaceutical companies and costs NHS patients.”

“There is absolutely no way to sugarcoat it. The numbers speak for themselves,” Cross told Al Jazeera.

Tim Bierley, campaigner for UK activist group Global Justice Now, said: “This latest study adds to the overwhelming evidence that the Trump drug risks significant harm to our health and economy.

“Billions of dollars that could be spent on NHS staffing, cutting GP waiting times and improving hospital care are about to be siphoned off by pharmaceutical giants.”

Here’s what we know about the report and what it means for health in the UK.

What’s in the US-UK deal?

This agreement, signed on December 1, was evaluated as a landmark agreement between British Prime Minister Keir Starmer and US President Donald Trump on pharmaceutical trade and pricing.

The United States has agreed not to impose tariffs on British pharmaceutical and healthcare exports for the next three years, until January 19, 2029.

According to a policy paper published by the British government, the preliminary understanding of the agreement recognizes that the United States and the United Kingdom share a “mutual interest in developing a global pharmaceutical system that supports the development and commercialization of new innovations.”

What are the findings?

In February, Vallance said funding for increased spending on medicines would come from the Department of Health and Social Care, which funds England’s NHS, rather than the Treasury.

The BMJ’s research shows that if spending targets are met and the economy grows as predicted by the Office for Budget Responsibility, the NHS will need to spend an extra £1.3 billion ($1.73 billion) a year by 2028. That’s about 25 million pounds ($33.4 million) per share. By 2036, this will increase to 8.8 billion pounds ($11.74 billion) per year, or about 170 million pounds ($227 million) per week. The agreement will bring the total amount to around 44.7 billion pounds ($59.7 billion) by the end of 2036.

“If you also take into account the impact on publicly funded adult social care, the costs become even higher: per £1bn modeled on UK local authority data. [$1.33bn] The NHS must find that adult social care costs will increase by £118m to fund the deal. [$157.5m] This is due to increased morbidity and mortality,” the report said.

Ultimately, the study predicted that excess deaths would likely occur as a result.

The report said: “Even if attention is limited to the direct impact of reduced available NHS spending, the deal is likely to result in around 229,000 excess deaths by 2036 – more than during the Covid-19 pandemic period from March 2020 to June 2022 (137,000). If indirect impacts on adult social care are also included, the increase in excess deaths is likely to be even higher. large (291,000),” the report said.

The report added that the findings were “unsurprising” given existing pressures on the NHS and “the large burden of unmet need in very cost-effective areas of care”.

It also referred to the lack of NHS funding and drug prices as an “opportunity cost”.

In health economics, opportunity cost is “at the heart of it all,” Cross said.

“Budgets are limited in the NHS. We are not made of money, and in this case, if you take money away to pay for more medicines, that is an opportunity cost where money has been diverted,” he explained.

Which health sectors will be most affected?

The study predicted that the highest number of deaths would occur in patients with cardiovascular, respiratory, gastrointestinal and cancer.

It added that it would cause greater harm to the quality of life of patients in these areas, as well as “neurological, endocrine, musculoskeletal and mental health problems”.

“Despite this evidence and confidence that ‘frontline services’ will be protected, the NHS will need to fund this deal from its allocations six months before the deal is agreed. The evidence suggests that additional public spending, if available, could be deployed more effectively within the NHS itself,” he added.

The report also called the government’s claim that the US-UK agreement would encourage pharmaceutical innovation in the country “unclear”.

“Pharmaceutical research and development operates in a global market in which the UK has a relatively small share, so there is limited evidence that UK domestic prices have a real impact on global investment decisions,” the report said.

“Nevertheless, there is evidence that in most cases the UK is already paying more than 100% for the long-term value of new drugs. Incentivizing the production of new drugs under this deal will be detrimental to the public health objectives of the NHS in the long term,” he added.

Cross added that there was no way for the government to offset the impact on services because money had actually been diverted away from the NHS.

“If the funds are used to pay for new drugs, positive health outcomes will be lost elsewhere, it’s as simple as that,” he said.

He called on the government to publish an impact assessment to spark public debate about how good the US-UK deal really is for the UK.

Bierley added: “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.”

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