NHS under fire as big pharma ramps up row over UK medicines spend and innovation stagnation

The battle between the NHS and pharmaceutical giants is reaching boiling point as accusations fly over the UK’s approach to funding modern medicines. A fresh row has ignited during President Trump’s state visit, with industry leaders demanding Britain pay more for life-changing drugs while government advisors insist patients are not losing out under current cost controls.

The National Institute for Health and Care Excellence NICE, pivotal in advising the NHS on medicines in England and Wales, reports a steady approval rate for new treatments. NICE approved 91 per cent of assessed medicines last year, up from 86 per cent previously. Product withdrawals by companies held steady at 18 per cent—unchanged over recent years. NICE’s official position remains that pressed budgets have not led to a loss of access for patients despite escalating cost pressures.

Still, the pharmaceutical sector is mounting a fierce challenge. Industry executives point to a doubling in the number of withdrawn drugs from NICE assessments over the last five years compared to the preceding five, blaming a rigid cost-effectiveness bar unchanged since 1999 while development costs have soared tenfold. Rebates demanded by the Treasury now surpass £3 billion annually, a massive jump from £500 million, further heightening discontent.

Fears of waning investment are becoming reality. In just the past week, US titan Merck cancelled plans for a £1 billion London R and D hub while AstraZeneca paused a £200 million project in Cambridge. Company bosses warn that unless the UK increases spending on breakthrough medicines, future investment will flow elsewhere, with other countries deemed to value innovation more highly.

Government figures are beginning to acknowledge the argument. Lord Vallance of Balham, science minister and former COVID chief adviser, conceded that Britain now spends only 9 per cent of its health budget on medicines—down from 12 per cent a decade ago and below the 13 per cent seen in many other developed nations. He told MPs a greater slice of the NHS budget must be allocated to drugs, even at the expense of other priorities, to maintain the UK’s health science leadership and competitive edge in clinical research.

Health minister Zubir Ahmed recognises pricing as a critical issue and supports an increase in funding for novel, disease-preventing treatments. He suggests a shift in spending could ease future pressure on admissions for major illnesses if preventive, innovative therapies are prioritised now.

The stand-off between government advisors determined to keep spending tight and multinational drugmakers seeking higher prices means the future shape of NHS investment is under the spotlight as never before. The cost of innovation—and who should ultimately pay—remains the central question for Britain’s world-renowned healthcare system.