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US trade deal on medicines will cost the NHS £45bn

The Guardian

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July 02, 2026

Cuts to services could cause 200,000 avoidable deaths, analysis finds

- Andrew Gregory

US trade deal on medicines will cost the NHS £45bn

The NHS will have to divert £45bn from essential services to pay for new medicines under the terms of the UK-US trade deal agreed last December, leading to more than 200,000 avoidable deaths of patients, analysis has found.

Ministers have defended the deal as a way of helping British drug exports to the US avoid tariffs, and giving patients in England access to potentially life-extending drugs that would otherwise be denied.

But they have been accused of caving in to US demands to spend billions of pounds a year extra on drugs supplied to the NHS after pressure from Donald Trump. The potentially devastating impact on NHS care has also caused growing alarm among health experts.

Now analysis, published in the British Medical Journal, lays bare the likely cost of the deal to the NHS - and the projected deadly impact of cuts to health services on the population in England - for the first time.

In total, £44.7bn in NHS cash will be diverted from health services by 2036 in order to pay more for new medicines under the trade deal, unless extra funding is made available to cover the additional costs, the analysis suggests.

Reduced NHS spending on services will have an adverse effect on the nation’s public health, the analysis found, causing 229,000 excess deaths by 2036. The estimated avoidable death toll is larger than the number that occurred during the Covid-19 pandemic, between March 2020 and June 2022 (137,000).

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