Intended for healthcare professionals


Prioritising patients in negotiations over drug pricing

BMJ 2023 ; 381 doi: (Published 14 April 2023) Cite this as: BMJ 2023;381:p829
  1. Robin Forrest , PhD candidate ,
  2. Huseyin Naci , associate professor
  1. Department of Health Policy, London School of Economics and Political Science, UK
  1. Correspondence to: H Naci h.naci{at}

Overpaying for medicines diverts funds away from other treatments and services

For over six decades, an agreement has been brokered every five years or so between the UK government and the drug industry, shaping the pricing and reimbursement landscape for medicines in the UK. 1 The latest iteration, the 2019 voluntary scheme for branded medicines pricing and access, 2 runs until the end of 2023. Negotiations for the next version of the agreement began in April.

The voluntary scheme promotes affordability by setting an annual growth cap of 2% on NHS spending on branded medicines. Spending beyond this level is repaid to the UK government by industry. The alternative to the voluntary scheme is a statutory scheme with less favourable terms for industry.

The government should strike a new deal that gets the most for patients out of its spending on medicines. Putting patients first in drug policy would ensure that the prices of branded medicines do not exceed their value to the NHS. The government should not pay more for the benefits of branded medicines than it pays for the benefits of other treatments and services already …

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