𝓤𝓷𝓲𝓽𝓮𝓭 𝓝𝓮𝔀𝓼

The NHS may need to pay more for medicines under plans to stave off tariffs threatened by US President Donald Trump, it has been reported.

Politico said proposals, including raising the threshold used by England’s NHS spending watchdog by 25%, had been briefed to Washington officials.

The Government has confirmed it is in “advanced discussions” with the US to “secure the best outcome for the UK”.

Charity Breast Cancer Now said raising the threshold could be a “game-changer” which would see “more people getting access to vital life-extending treatments”.

But other experts suggested the cost could put pressure on the NHS budget.

The National Institute for Health and Care Excellence (Nice) assesses medicines based on a number of factors including clinical effectiveness, cost effectiveness and the overall cost to the NHS.

This is done using using an assessment called quality-adjusted life years (QALYs), which combines both the length of life gained from a treatment and its impact on quality of life, represented as a number.

In general, Nice considers medicines costing between £20,000 and £30,000 per additional QALY gained to represent good value for money for the NHS.

Increasing the threshold would make it easier for NHS patients to access more expensive drugs, but it would also mean the health service pays more for medicines overall.

It comes after science minister Lord Patrick Vallance conceded an increase in the price the NHS pays for medicines will be “necessary” to prevent pharmaceutical investments from continuing to leave the UK.

Major firms have shelved or paused planned UK pharmaceutical industry investments this year, and industry bosses recently told MPs a “difficult” environment and pressure on pricing had made Britain a less attractive investment environment than other countries such as the US.

It is understood Mr Trump wants more parity on drug pricing, with drug prices in the US higher than anywhere else in the world, and he has threatened to impose tariffs of up to 100% on pharmaceutical imports.

A Government spokesperson said: “The pharmaceutical sector and the innovative medicines it produces are critical to our NHS, our economy and the Plan for Change.

“Through our Life Sciences Sector Plan, we’ve committed to working with industry to accelerate growth in spending on innovative medicines compared to the previous decade.

“We’ve secured a landmark economic partnership with the US that includes working together on pharmaceutical exports from the UK whilst improving conditions for pharmaceutical companies here.

“We’re now in advanced discussions with the US administration to secure the best outcome for the UK, reflecting our strong relationship and the opportunities from close partnership with our pharmaceutical industry.”

A Nice spokesperson said: “In a health system such as ours funded by general taxation, it is for the Government to decide how much to spend on health in the context of other spending priorities within the health system and beyond.

“In that context Nice is aware of on-going discussions in Government over the level of medicine spend.”

Azeem Majeed, professor of primary care and public health at Imperial College London, said a change to the threshold would “increase access for NHS patients to innovative treatments that were previously excluded on grounds of excessive cost relative to their clinical benefits.

“However, this change would also put increased pressure on the NHS budget.

“It is difficult to quantify the extra spending that might result from a wider range of drugs becoming available for use in the NHS through this change but any extra spending on these treatments would have to be matched by reductions in spending on other health services.”

Claire Rowney, chief executive at Breast Cancer Now, added: “If, as reports suggest, the Government were to significantly increase the cost-effectiveness threshold for medicines, this could be a game-changer that sees more people getting access to vital life-extending treatments.

“For too long cost-effectiveness thresholds have jeopardised the approval of some groundbreaking new medicines.”

Dr Dan Howdon, associate professor in health economics at the University of Leeds, said: “It is important to be clear that any proposed increase to the threshold cannot be backed by the weight of existing research in this area, if the aim of healthcare spending is to improve population health.

“This research strongly suggests that the cost-effectiveness threshold is already set too high, and the effect of accepting new treatments at this rate is to reduce population health.

“I am not aware of any research, taking improving the health of the nation as the goal of healthcare spending, that suggests it is too low. Any move to increase the threshold would be motivated by twin pressures that are geopolitical and from the pharmaceutical industry.”