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Drugs bill warning over US/UK trade deal

The NHS would spend billions of pounds more on drugs if it had to pay US prices following a US/UK trade deal. According to a new study by researchers at Brigham and Women’s Hospital in Boston, Harvard Medical School, and the University of Oxford, published by the Journal of the Royal Society of Medicine, NHS England would have spent over £5 billion more on 50 brand-name prescription drugs widely used in primary care if it had paid US prices in 2018. Drugs on the list included a variety of commonly used medicines, including treatments for diabetes, inhalers and anticoagulants.

Prescription drug prices in the US far exceed prices in the UK, where there are price controls in place to limit NHS spending and restrict the profits that drug manufacturers can earn. The analysis shows that if NHS England had paid US prices for the 50 costliest drugs used in primary care in 2018 it would have spent 4.6 times as much, an increase from £1.39 billion to £6.42 billion.

It is currently unclear whether prescription drug prices will be included in any trade deal between the US and UK following Brexit. The UK government has previously stated that the NHS would not be part of a trade deal with the US, but a recent summary of negotiating objectives stated that the US Trade Representative is pursuing ‘full market access’ for US pharmaceuticals in the UK.

Lead researcher Michael Liu said: “The UK is working towards a range of external trade deals, which is great news. Our paper sounds a note of caution around the NHS medication spend: if drug prices were to be included in a US/UK trade deal, and current cost-containment mechanisms were compromised, this could result in drug prices more similar to those of the US.”

“Because the scale of this difference in pricing is so substantial, we have modelled the possible excess costs, applying current US price data to current UK medicines usage data. We hope this provides helpful context for those evaluating different trade options.”

Notes to editors

Projected spending for brand-name drugs in English primary care given US prices: a cross-sectional study by Michael Liu, Brian MacKenna, William B Feldman, Alex J Walker, Jerry Avorn, Aaron S Kesselheim and Ben Goldacre (DOI: 10.1177/0141076820918238) will be published by the Journal of the Royal Society of Medicine at 00:05 hrs (UK time) on Friday 11 September 2020.

The link for the full text version of the paper when published will be:

For further information or a copy of the paper please contact:

Rosalind Dewar
Media Office, Royal Society of Medicine
DL: +44 (0) 1580 764713
M: +44 (0) 7785 182732

The Journal of the Royal Society of Medicine (JRSM) is a leading voice in the UK and internationally for medicine and healthcare. Published continuously since 1809, JRSM features scholarly comment and clinical research. JRSM is editorially independent from the Royal Society of Medicine, and its editor is Dr Kamran Abbasi.

JRSM is a journal of the Royal Society of Medicine and it is published by SAGE Publishing.

Sara Miller McCune founded SAGE Publishing in 1965 to support the dissemination of usable knowledge and educate a global community. SAGE is a leading international provider of innovative, high-quality content publishing more than 1000 journals and over 800 new books each year, spanning a wide range of subject areas. A growing selection of library products includes archives, data, case studies and video. SAGE remains majority owned by our founder and after her lifetime will become owned by a charitable trust that secures the company’s continued independence. Principal offices are located in Los Angeles, London, New Delhi, Singapore, Washington DC and Melbourne.

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