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Analysis

Trump will bully NHS into paying billions extra for US drugs

by Sam Ashworth-Hayes | 14.11.2019

Donald Trump is so chuffed that he has brokered a deal between Boris Johnson and Nigel Farage that he will expect a quid pro quo. And our Prime Minister will be so desperate for a US trade deal that the American president will have him over a barrel. 

One of Trump’s top demands will be that the NHS pays more for American drugs. After all, he said last year that foreign countries are “freeloading” by paying “a tiny fraction of what the medicine costs in the USA”.

In the UK, the National Institute for Health and Care Excellence (NICE) plays a major role in negotiating medicine prices. If it recommends a drug, the NHS is legally obliged to fund its use. As the NHS is not funded by a limitless supply of money, NICE uses cost-effectiveness thresholds for recommending treatments – forcing American companies to charge reasonable prices if they want to sell to the NHS.

While this is good for patients, it angers the American pharmaceutical lobby. It wants “competitive market-derived pricing” and “full market access” from any UK trade deal. That  goal has made it into the list of US negotiating objectives. What’s more, drug pricing has already been discussed in six meetings between UK and US trade officials, according to Channel 4’s Dispatches.

If the US gets its way, the NHS would be expected to fund medicines regardless of their cost-effectiveness. With costs rising and budgets limited, patients will suffer.

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The Americans have form in this area. When they negotiated the US-South Korea trade agreement, they included a section that restricted the use of national price controls. Instead, Korea’s health service would pay “competitive market-derived prices”, or at the least “appropriately recognise the value of the patented pharmaceutical product”.

The US has also pushed Canada and Mexico to give its pharma companies longer monopolies on new drugs. When it renegotiated NAFTA, it insisted on protecting new biologic drugs from generics for “at least ten years” – compared to five years in Mexico and eight in Canada.

Why do we think that a UK which has just lost full access to the EU market would be in a better place to stand up to bullying than Canada, South Korea or Mexico?

An extra £12bn a year?

To get an idea of how much this could cost, look at the 20 medicines the NHS spends the most on. Dr Andrew Hill (University of Liverpool) and his colleagues compared the prices paid in Britain with the lowest price offered for each drug in the US. If the NHS was forced to pay that, it would have to cough up almost £12 billion more every year – an extra £226 million every week.

Brexiters may argue that we wouldn’t immediately jump to American prices for those drugs, but that misses the point. Today, these drugs are cheap. Tomorrow, new drugs would be expensive, and not just those sold by Americans. Longer patent periods and market pricing would allow pharmaceutical companies from other countries to charge inflated prices as well. 

If we want a US trade deal and a healthy NHS, the best solution is to negotiate from a position of strength. And the best way to do that is to stay in the EU, the largest trade bloc in the world.

Edited by Hugo Dixon

Categories: Sovereignty, UK Politics

4 Responses to “Trump will bully NHS into paying billions extra for US drugs”

  • It’s worth noting the views of an Australian academic, Dr D Gleason, on the so-called Healthcare Transparency Annex in the Trans-Pacific Partnership (a part of that trade deal pushed by the US). Here are two short quotes:
    “The purported aim of the Annex is to facilitate ‘high quality healthcare’ but the Annex does nothing to achieve this. It is clearly intended to cater to the interests of the pharmaceutical industry.”
    “While the language of the Annex is framed around principles of transparency and fairness, the objectives of the pharmaceutical and medical device industries clearly go much further than this. The ultimate objective of the industry is expanded market access at monopoly prices dictated by the industry.”

  • The NHS will be destroyed by a Tory majority that leads to Brexit. Remember no deal is still on the cards should he win.
    Today’s statistics on the NHS are shocking and the system is creaking, Johnson has LIED again on camera saying that the pressure on the NHS is the result of increased demand. It is not. The chairman of the BMA states that is down to under funding and a failure to invest in the infrastructure of the service. The U.K. has a shortage of beds, nurses and doctors. Also the time allowed for individuals in an appointment with their GP is a mere ten minutes, the lowest in Europe. Patients are allowed to mention one problem only. If they have the symptoms of a second illness/problem they are told to make another appointment. As Hugo has said Johnson’s lies on the NHS and everything else must be highlighted and published and promulgated. Austerity has put the NHS on its knees. Trump would destroy it.
    Johnson is a danger to the health of this nation. His is a joker using ‘big’ words which are meant to be comical (the words begin with W, M and O). He is immature and to think he is the PM is frightening.

  • This has been widely discussed in a number of UK media that anyone with a slight modicum of brain could have accessed in the same way that you access the usual garbage media: at a news stand. Clearly, the Andy Capps in male and female form in this world are not open to these issues and declare themselves “tired of Brexit”.

    This is Project Fear to them and the only way to find out about what’s awaiting them is the hard way. The same way the US population suffers; and it is going to be a painful road to travel.

    Tough!

  • Unfortunately those of us not so gullible, not too lazy to do research will be dragged along with them and suffer because of it!