A newly published study in the British Medical Journal says that the US–UK pharmaceutical deal agreed last December could lead to 229,000 excess deaths in England by 2036 if the NHS has to divert money from other services to pay for it. That’s more than the 137,000 deaths recorded during the first two and a half years of the Covid pandemic. If the knock-on effect on adult social care is included, the projected death toll rises to 291,000.
For anyone who cares about the NHS, public health, or just fairness in trade deals, this is not a minor technical issue – it’s a massive policy failure that will hurt real people, especially the sick, the elderly and those with chronic conditions.
For anyone who cares about the NHS, public health, or just fairness in trade deals, this is not a minor technical issue – it’s a massive policy failure that will hurt real people, especially the sick, the elderly and those with chronic conditions.
What the deal actually does
The core of the deal is simple but brutal:- The UK has agreed to pay 25% more for new medicines over the next decade.
- The NHS in England, which currently spends about £14.4bn a year on innovative therapies, will have to double the share of GDP it allocates to buying such products – from 0.3% to 0.6%.
- The government says the deal will cost an extra £1bn between 2025–26 and 2028–29, but admits costs will rise after that without giving any official estimates.
- Independent analysis in the BMJ, by researchers from the University of York, University of Liverpool and a hospital in New Zealand, says the annual cost to the NHS will surge to £8.8bn by 2036, with a total bill of £44.7bn by then.
- A separate Bureau of Investigative Journalism report suggests the true cost could be closer to £64bn, with researchers predicting up to 330,000 excess NHS deaths by 2036.
Why this is bad for British citizens
1. Massive loss of NHS capacity
To pay for the deal, the analysis says £44.7bn will be diverted from essential NHS services by 2036. That means:- Less funding for hospitals, GP services, community care and prevention.
- More cuts to staff, waiting lists, diagnostic services and treatment for long-term conditions.
- A system already under pressure from years of underinvestment now being deliberately starved of resources to pay for higher drug prices.
2. Hundreds of thousands of avoidable deaths
The BMJ study links the funding shortfall directly to mortality:- Reduced NHS spending on services will have an adverse effect on public health, causing 229,000 excess deaths by 2036.
- Most of these preventable deaths would be among people with heart disease, respiratory disease, gastrointestinal disease or cancer.
- Including adult social care, the figure rises to 291,000 excess deaths.
3. A deal designed to please Trump and Big Pharma, not patients
The government’s own defence of the deal is telling:- Ministers say it helps British drug exports to the US avoid tariffs of up to 100% that Trump threatened to impose.
- They claim it gives patients access to life-extending drugs they would otherwise be denied.
- But critics argue the UK is effectively caving in to US demands to spend billions more on drugs after pressure from Donald Trump.
- A way of “pacifying Donald Trump and big pharma’s demand for higher medicines prices”.
- A “complete insult to patients who are suffering and dying on hospital trolleys”.
- A “national scandal” where “tens of billions of pounds” are taken out of the NHS and put into the back pockets of pharmaceutical companies.
4. No proper scrutiny, no parliamentary vote
One of the most worrying aspects is how the deal was handled:- The deal was not subject to any scrutiny in parliament before being “rushed through”.
- The government has refused to publish its own secret impact assessment of the trade deal.
- Freedom of Information requests about the deal have been refused.
Bottom line
According to the BMJ analysis, the US–UK drug deal could:- Divert £44.7bn from other NHS services by 2036.
- Cause 229,000 excess deaths in England by 2036, rising to 291,000 if social care is included.
- Cost far more than the government’s official figures – possibly £64bn.