That’s gratitude, eh? It’s not even a fortnight since the government agreed to raise the prices the NHS pays for new medicines and here comes the boss of GSK, Britain’s second largest pharma firm, to extol the virtues of doing business in the US.
The US is “still the leading market in the world in terms of the launches of new drugs and vaccines”, said the chief executive, Emma Walmsley, in a BBC interview, explaining why GSK invests about three times as much over there as it does at home. Alongside China, the US is also “the best market in the world to do business development”.
Her comments have caused a stir but, actually, are merely a statement of reality. It would be absurd to pretend the UK has suddenly shot to the top of the competitiveness table in life sciences as a result of the multipronged price and tariffs deal at the start of this month.
Yes, the UK retains excellent research facilities, links with universities and other soft “ecosystem” benefits – successive governments’ boasts about the UK being a life sciences “superpower” are not wholly fanciful. But the US remains streets ahead in terms of what it spends on new drugs, the depth of its research and manufacturing bases and the funding its startups and biotech businesses can raise. That’s just how things are.
But, as Walmsley also said, this month’s deal on NHS prices and tariffs is welcome. Critics complain the terms represent a capitulation to big pharma and Trump. But what else was the government supposed to do? If it is serious about the “superpower” stuff, it had to avert tensions that existed long before the president threatened to impose tariffs at nose-bleed rates on UK pharma exports to the US.
Quarrels over NHS pricing were plainly related to lost investments in the UK, such as Merck’s scrapping of a £1bn research centre in London. One issue was the complicated “voluntary” price scheme, which tries to promote innovation while protecting the NHS budget via a cap. Companies’ rebate payments have been unpredictable and last year’s tally was 23% of sales, far above comparable rates in other large European countries. The other issue is the price the National Institute for Health and Care Excellence (Nice) allows the NHS to spend on life-extending drugs.
The deal wrapped the items together. The UK got zero tariffs on exports to the US for three years. The price rebate was capped at 15%. And Nice raised its baseline price thresholds by 25% at the lower end.
Cue the complaints about NHS budgets being diverted from frontline equipment and hospitals. Yes, that is undeniably a risk: the health service’s spending on pharmaceuticals will rise by £3bn a year. But the alternative was less investment in the UK, which might create even more pressure on budgets over time and even less access for patients to new medicines. In a world of trade-offs, and from a tricky negotiating position, the government looks to have landed in roughly the right spot. A deal had to happen, as argued here many times.
Walmsley called it “a step in the right direction”, which is positive but not a five-star review. That is probably also fair. The plan is for the UK to double to 0.6% the percentage of GDP spent on new medicines over a decade, which leaves plenty of time for tensions to flare again. Meanwhile, the terms of the post-2029 “voluntary” scheme also have to be negotiated.
But other projects are happening in the wings, such as the £600m-backed Health Data Research Service, which aims to “turbocharge access to NHS data for researchers” by exploiting the health service’s strength as a unified system. At a time when the government’s industrial strategy seems to be moving in slow motion on several fronts, the position in life sciences could easily have been worse. It’s just that the pull of US will, undeniably, remain strong.
