Keir Starmer’s disastrous trade deal with Trump for US pharmaceuticals may end up costing the UK £64bn. That’s massively over the £1bn estimate that the government itself gave to the public. Worse still, the money diverted from other NHS services may cost hundreds of thousands of lives over the coming decade.
That’s according to explosive reporting from the Bureau of Investigative Journalism. The *Bureau,*in turn, used economic modelling from a team at the University of York, lead by professor Karl Claxton. This professor previously sat on the appraisal committee for the the National Institute for Health and Care Excellence (NICE), the national body which decides which pharmaceuticals the NHS can purchase.
Claxton found that the UK government’s £1bn estimate of the deal’s most immediate costs should be closer to £3.3bn. However, he also argues that number will balloon to £64bn when we take account of the government’s commitment to double its pharmaceutical spending levels by 2036.
If this eye-watering figure proves accurate, the effects on public health in the UK could be devastating. Claxton’s team predicted that an extra 330,000 people could die within the next decade as a consequence of money being diverted from other NHS services to meet the deal’s demands.
Starmer opening the NHS up to more dire straits
The US-UK pharma deal made commitments for the NHS to spend more on both new and existing drugs from the States. It also lowered the bar for cost-effectiveness in NICE appraisals. This, in turn, may mean that the NHS could spend more on less-effective medicines.
However, the deal also means that there will be no tariffs on UK pharmaceuticals heading to the US. As such, Westminster have tried to spin it as a victory. A UK government spokesperson called the deal:
a vital investment that builds on the strength of our NHS and world-leading life sciences sector to increase access to lifesaving medicines without taking essential funding from our frontline NHS services.
Meanwhile, critics have accused the deal of diverting money away from other vital NHS services. The Bureaureported that independent experts had said:
the deal will affect every NHS patient, from increased mortality and reduced survival related to cancer, respiratory and gastrointestinal diseases, to reduced quality of life for people with neurological, endocrine and mental health problems.
A £64bn total
Likewise, Prof. Claxton argued that:
The best way to spend it isn’t to give it to pharma. The best way to spend it is to increase the NHS or adult social care budgets.
Unsurprisingly, both Starmer’s government and the Association of the British Pharmaceutical Industry (ABPI) have been quick to contest Claxton’s findings. The ABPI called the research “fundamentally flawed”, while a Westminster spokesperson said it was:
based on assumptions and projections that the government does not share and do not reflect how decisions on medicines funding and access are made in practice.
However, NICE stated that it was aware of the York team’s findings, along with other critical studies. The pharmaceutical spending watchdog confirmed that it “takes such analysis seriously”, and added that:
NICE continuously reviews and updates its methods to ensure they continue to represent best practice in health technology assessment.
Zero transparency
In spite of the potentially dire repercussions, the UK government has been utterly opaque on the details of the deal. They’ve denied freedom of information requests from activists and journalists regarding key details, and even left minister’s’ questions virtually unanswered.
Likewise, the Bureau sent FOI requests to the Department of Health and Social Care (DHSC) and Department for Science, Innovation and Technology (DSIT). Rather than asking for details on the deal itself, the Bureau asked for an assessment of the potential health impacts. Still, both departments refused:
DHSC said that releasing the information could undermine the UK’s negotiating position and damage future “commercial relations with the pharmaceutical sector”. DSIT, meanwhile, confirmed the existence of an unpublished annex to the impact assessment but said it will not make it public due to “international relations”.
The Association of the British Pharmaceutical Industry (APBI), the trade body representing UK pharmaceutical companies, stated that it:
does not discuss the details of confidential industry discussions with the government.
‘Absolutely no parliamentary scrutiny’
Understandably, activist groups and parliamentarians have expressed fury at this lack of opportunity for public scrutiny. MSP Seamus Logan, for example, asked:
We’re not allowed to see it because it might upset Donald? That’s appalling. That’s absolutely appalling.
There has been absolutely no parliamentary scrutiny of the workings of this deal to date, and there absolutely must be. We need to know what the cost of this deal really will be.
In fact, Scottish government representatives confirmed that Holyrood had been:
given no role in the process – despite the clear impact on Scotland and our NHS.
Similarly, Nick Dearden – of human rights group Global Justice Now – said:
When it comes to a piece of domestic policy regulation like NHS price controls, I find it extraordinary that the public or parliamentarians are not allowed to see their calculations.
It is outrageous in and of itself that Starmer caved in to pressure from Trump on NHS pharmaceutical spending. However, the fact that parliament is denying even basic scrutiny of the deal heaps further insult onto that injury.
Meanwhile, as Claxton’s research shows, there are massive question marks over whether the deal’s impact on UK public health may in fact be worse than whatever tariffs Trump could have thrown at us. A trade agreement of this magnitude must face public examination – after all, it’s the public’s health that’s at stake.
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