UK-US pharmaceuticals deal will divert £45bn from essential NHS services, says doctors' union

The NHS will be forced to divert around £45bn from essential services under a UK-US pharmaceuticals deal, increasing potentially preventable deaths by 229,000, analysis from a doctors' union has found.

The "landmark" deal, announced in December 2025, aims to improve access for NHS patients to new life-changing treatments that would otherwise be rejected.

The government said it makes the UK the first country in the world to secure commitment to 0% tariffs on pharmaceutical exports to the US, for at least three years.

Analysis from the British Medical Journal (BMJ) says the trade 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.

It says the diversion of NHS funds to pay more for new drugs will impact population health, leading to 229,000 excess deaths by 2036 and increased health inequalities.

The largest estimated impacts on deaths would be across cardiovascular, respiratory and gastrointestinal disease and cancer, according to the analysis.

The BMJ, a subsidiary of the British Medical Association, argues that reallocating an equivalent £44bn into existing health services would prevent more than 287,000 deaths by 2036, particularly in areas of high mortality and deprivation.

The deal has also come under further criticism. Sally Gainsborough, senior policy analyst at the Nuffield Trust, said: "We now have two bits of government that are in contradiction with each other.

"We have a deal that is using the NHS resources in a way that is contradictory to the NHS constitution.

"At the very least, the government should publish the details and the analysis on which it has made that really very radical change to our health care system."

The deal will see the UK government invest around 25% more in "innovative, safe, and effective treatments" over the next decade.

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It has committed to increasing expenditure on new medicines from 0.3% to at least 0.6% of GDP in 2036, according to the analysis.

This means the additional annual costs to the NHS will be at least £1.3bn in 2028 (£25m per week), and £8.8bn in 2036 (£170m per week).

The cumulative additional cost of the trade deal will be £2.6bn by the end of 2028 and £44.7bn by the end of 2036, per BMJ estimates.

The deal forms part of broader UK-US trade and economic negotiations and commits the NHS to much higher spending on branded medicines over the coming decade.

Some drug industry bosses praised the deal, saying it would avoid Donald Trump's threatened 100% tariff on patented pharmaceuticals coming into the US.

But MPs, including Labour ex-shadow chancellor John McDonnell, have also voiced concern.

Mr McDonnell said in April: "The changes the government are making to Nice as a result of the US pharmaceutical deal undermine the independence of Nice, giving US big pharma the potential of immense influence over our drugs policies."

UK-based campaign group Global Justice Now said that by agreeing this deal, the government is "taking an axe to the NHS to pacify Donald Trump and big pharma's demand for higher medicines prices".

It said: "If the government truly cared about patient access to medicines, it would tackle the profiteering corporations that hold us to ransom."

In February, Patrick Vallance, the science minister, confirmed that the costs - initially an additional £1bn across three years - will be met by the Department of Health and Social Care, which funds the NHS in England, rather than the Treasury.

A Department of Health and Social Care spokesperson said: "Through our partnership with the US, we have reformed medicine pricing, allowing NHS patients to access life-changing new medicines they previously would have been denied. We are also making the UK one of the best places in the world to develop, launch and manufacture new medicines.

"The £45bn figure is not recognised by the department. The deal will be funded by allocations made at the Spending Review, where record funding for the NHS was secured. Future funding will be settled at the next Spending Review."

(c) Sky News 2026: UK-US pharmaceuticals deal will divert £45bn from essential NHS services, says doctors' union