Given its foundation on socialist ideals, it was expected that Donald Trump would not support the NHS. What particularly irked him was the NHS’s adeptness at securing favorable deals, a feat made possible by its large-scale operation which made it impervious to pressure from major pharmaceutical companies. However, with Trump assuming the presidency, the dynamics have shifted.
Reports suggest that the UK government is contemplating a 25% increase in the NHS’s “value for money” benchmarks to accommodate higher payments to pharmaceutical companies, many of which are American-based.
While Trump argues that the exorbitant drug prices in the US subsidize research and development costs for innovative drugs, benefiting countries like the UK with their lower costs, the fundamental issue lies in the US healthcare system’s inability to negotiate effectively compared to a unified national health service like the NHS.
Trump has threatened to impose tariffs of up to 100% on pharmaceutical imports if countries such as the UK do not agree to pay more for drugs. This move could have dire consequences for the UK’s pharmaceutical industry, prompting intense negotiations by the government to find a resolution.
Capitalizing on the situation, major pharmaceutical companies have seized the opportunity to weaken the NHS’s collective bargaining power for better deals. This maneuver has already led to significant repercussions, such as Merck abandoning a substantial research project in London and AstraZeneca pausing investments in the UK.
Confronted with these challenges, the UK government is reportedly considering instructing the National Institute for Health and Care Excellence (NICE) to raise the value-for-money threshold by 25%, a move aimed at securing continued engagement from global pharmaceutical companies post-Trump era.
Despite attempts to portray increased spending by the UK and the NHS endorsing pricier drugs as beneficial for patients, experts familiar with the healthcare landscape argue otherwise. NICE evaluates medicines based on various criteria, including clinical and cost effectiveness, using a metric known as quality-adjusted life years (QALYs).
With the current NHS expenditure on medicines and medical devices amounting to around £20 billion in England, a 25% hike in NICE thresholds could translate to billions more spent on drugs by the NHS.
Dr. Dan Howdon, an associate professor in health economics, contends that existing estimates already indicate that NICE’s value-for-money thresholds are set too high. Any proposal to raise these thresholds, according to him, is influenced primarily by geopolitical and pharmaceutical industry pressures rather than robust research backing.