How Trump wants to force the NHS to pay more for medicines

How Trump wants to force the NHS to pay more for medicines


By: Heidi Chow
Date: 2 December 2019
Campaigns: Pharma, Trade

Boris Johnson’s government has been adamant that drug pricing is not on the table for a trade deal with Trump. But the leaked trade papers of their secret meetings with the US exposed that this is simply not true. In fact, discussions on drug pricing have not just been taking place between the UK and US negotiators, they are very advanced. The papers say:

“We have reached a point (for Patents in Pharmaceuticals/Health) where beyond specific policy details in niche areas, we are awaiting the clearance to negotiate and exchange text to really take significant further steps.” [1]

From the second meeting onward, the topic of pharmaceutical patents has been a major item on the agenda, with an in-depth discussion in the fourth working group. The two sides have effectively concluded all the preliminary negotiations they need on this subject and are ready to move to the next stage of agreeing text.

What is being proposed is the extension of monopolies for big drug companies, particularly on new ‘biologic’ medicines – an advanced class of effective drugs used to treat autoimmune diseases and cancers. This would force the NHS to pay higher prices for longer and could massively hike up the NHS drugs bill to unsustainable levels.

It’s no wonder that drug pricing has been on the table. Trump and his administration have made no secret that they blame high drug prices in the US on “‘freeloading’ from other countries’ socialised” health systems [2] and want to use trade deals to rectify this. In a speech last year, President Trump said:

“I have directed US trade representative Bob Lighthizer to make fixing this injustice a top priority with every trading partner. And we have great power over trading partners” [3].

The leaked papers confirm that the US have expressed this directly the UK negotiators, saying:

The US said there is a lot of conversation on drug prices and looking at what other countries pay and this is causing angst. There are worries that the US is not getting a good deal in pharmaceutical industries.” [4]

Getting the NHS to pay higher prices is a key priority for the US negotiators. At present the NHS’ bulk purchasing power allows it to negotiate prices, while the regulator, NICE, assesses whether medicines are effective enough to justify their price. These price control mechanisms are all under threat in a trade deal with Trump.

And if there were any doubt about the undue influence of big pharma, the leaked papers also revealed that there was:

“a series of positive bilateral stakeholder meetings with the American Creative, Technology, and Innovative Organisations Network (ACTION) for Trade, the Pharmaceutical Research and Manufacturers of America (PhRMA), the Association of American Publishers (AAP) and the Association for Accessible Medicines (AAM). DIT [Department of Trade] and IPO [Intellectual Property Office] met with representatives from each organisation to discuss USMCA [Trade agreement between the US, Canada and Mexico] and priorities for each stakeholder for future trade agreements.” [5]

In other words, British trade officials combined the trade talks with lobby meetings with powerful pharmaceutical industry bodies. This corroborates the revelation in Channel 4’s Dispatches programme that the government had held five secret meetings [6] with representatives from the US pharmaceutical industry.

President Trump and his administration have already made it very clear that they want the NHS to pay more for medicines. It’s in US negotiating objectives [7] and the leaked documents [8] confirm that the government has allowed it to be discussed in trade discussions.

It’s now up to us to keep spreading the word to expose this agenda and stop this toxic trade deal. 




[1] p132



[4] p48

[5] p43