UK-USA drug deal could cost the NHS billions and cause over 200,000 excess deaths, according to BMJ study
A study published in the BMJ this week claims that the NHS will need to divert around £45bn from services to pay for new medicines resulting from the trade deal agreed last December. A consequence of diverting expenditure will be an estimated increase in avoidable deaths of over 200,000.
At the time of the deal, the government welcomed the agreement as a positive move towards reducing the drug tariff that British drug exporters faced in the USA, providing patients in England with greater access to essential medicines. But the study in the British Medical Journal (BMJ) analyses the estimated costs of the deal and the impact on patients of diverting resources.
In December 2025, the agreement secured a 0% tariff on UK pharmaceutical and medical device exports to the US for the next three years, as part of broader trade and economic negotiations, including life sciences and pharmaceuticals. The quid pro quo was a commitment that the NHS substantially increased expenditure on branded medicines through changes to drug pricing arrangements and health technology assessment, a commitment that, if not funded outside of NHS resources, will create significant opportunity costs in the system.
According to the study:
- The deal more than doubles the amount of money the NHS will pay for new medicines over the next 11 years, costing an additional £44.7bn by the end of 2036
- Diversion of NHS funds to pay more for new drugs will be detrimental to population health, leading to 229 000 excess deaths and increased health inequalities
- Ministers have emphasised proposed benefits of the agreement, including incentives for innovation and access to new medicines, but the longer-term implications for NHS expenditure and service provision remain insufficiently accounted for
- Greater transparency, including publication of the health department’s impact assessment, would support more informed public and parliamentary debate about pharmaceutical pricing policy
You can read the full study here.
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