Recommendation 4

The UK-US pharmaceutical agreement has secured benefits— notably exemption from tariffs—but it also appears to have involved significant commitments affecting core elements of UK domestic policy. Changes relating to medicine spending, NICE thresholds, and the Voluntary Scheme for Branded Medicines Pricing, Access and Growth (VPAG) are key to UK health policy, and it is disappointing that it is external pressure rather than discussion within the UK that seems to have led to change. It also raises the question of how far the UK can rely on its strategic relationship with the US. Although the global nature of the pharmaceutical sector inevitably means that trade negotiations will have an impact, decisions about NHS spending, pricing, and access to medicines should primarily be driven by the needs of UK patients, balanced with the sustainability of the life sciences sector. (Conclusion, Paragraph 35)