Trump’s Plan For The NHS: Channel 4 Dispatches

29 October 2019

Trump’s Plan For The NHS: Channel 4 Dispatches

Monday 28th October, 8pm, Channel 4

The price the NHS pays for US medicines could soar under a trade deal with America after the UK leaves the European Union, according to an investigation by Dispatches.

Despite Prime Minister Boris Johnson’s assertion that the NHS is not on the table, Dispatches hears from sources with knowledge of the initial trade discussions between the two countries who question whether this is the whole story.

Reporter Antony Barnett discovers that “drug pricing” has been discussed in six initial meetings between trade officials from the two countries and learns of secret meetings between US drugs firms and British civil servants where medicine “price caps” have been talked about. 

• Dispatches was also told that British trade officials have been warned that the subject is so sensitive that they must not mention “drug pricing” in emails but use the term “valuing innovation”.

US government and its powerful pharmaceutical industry want the NHS to pay more for their medicines which are much more expensive across the Atlantic. They want to remove the UK’s ability to block American drugs not deemed “value for money” and restrict our powers to allow cheaper alternatives to be prescribed to patients which save the NHS hundreds of millions of pounds a year.

According to research carried out for the programme, the cost to the UK government could run into the billions, approximately £27 billion, wiping out the potential Brexit bonus for the NHS promised by Boris Johnson.

Interview with Stephen Vaughn, previously general counsel for the Office of the US Trade Representative:

Barnett travels to Washington and hears how the price of medicines is a major political issue in the US, with President Trump blaming “foreign freeloaders” who he believes pay lower prices for US drugs, thanks to the high prices Americans pay. He has instructed his negotiators to make ‘ending this injustice’ a priority in trade talks. 

In an interview with the programme, one of Trump’s former top trade negotiators Stephen Vaughn said he doesn’t understand what Boris Johnson means when he says the “NHS is not on the table”

Asked what happens when one side in trade negotiations says the NHS is off the table, Vaughn said: “Well that that really goes to the question of what the UK government means when it says the NHS is off the table. I don't know what they thought they meant when they said that. “

Until April this year, Vaughn was the top lawyer in the Office of the US Trade Representative and a key player in recent trade deals with Canada, Mexico and South Korea which saw the US win key concessions over the price these countries paid for US medicines.

Vaughn said: “I would expect U.S. negotiators to see what we could do in terms of getting increased access to the British market. That's what we do… I think it's going to be likely to come up because the US mentioned pharmaceuticals in its negotiating objectives”

Barnett also speaks to one of Trump’s closest allies, Republican congressman Mark Meadows who says that drug pricing has to be on the table in any trade deal with the UK. “It needs to be part of the negotiations …my aim is to have pharmaceutical negotiations being part of any international negotiation. Why should an American patient have to pay a thousand dollars for a drug when other countries can buy the same drugs at a fraction of the cost?”

 

Rising cost of drugs:

The programme focuses on the drug Humira made by US drugs company AbbVie.  Humira is used to treat 46,000 patients in the UK who suffer from diseases like rheumatoid arthritis and Crohn’s disease. For the NHS it is the single most expensive drug, costing £450m a year. Last year, the NHS started prescribing cheaper alternatives to Humira that will save the health service £150m a year – equivalent to thousands of doctors and nurses.

Dispatches follows Ciara, 20, who’s being swapped from Humira to a cheaper alternative for the first time.

Unlike here, patients in the US will not be allowed to be prescribed cheaper alternatives to Humira until 2023. Trade experts fear that should a trade deal be signed with America, then the US administration will force Britain to adopt similar policies. In recent other US trade deals this has emerged as an important issue.  

Dr Andrew Hill from Liverpool University calculates that adopting the US system of drug pricing, could cost the NHS £2.9bn alone for Humira. Dr Hill also calculates that if the US government and drug firms get their way in trade negotiations, the total extra cost to the UK could be £27bn.

Hill said: “We're talking about billions of pounds...we've got to go in with our eyes open, understanding just the crazy amounts of money that are involved. “

Former Conservative Health Secretary Andrew Lansley thinks the Government should publish what the UK’s negotiating objectives are and rule out drug pricing from a trade deal with America.

“Medicines pricing in the United Kingdom is too significant an issue and too important for us to maintain, for us to go down that path. The Americans have set out what their negotiating objectives are. They did that back in February. Actually, the British government should set out what our negotiating objectives are. It would be a start. We don’t at the moment know what those are.”

 

Government response:

In a statement to Dispatches, the Department for International Trade said: “The NHS is not, and never will be, for sale to the private sector, whether overseas or domestic‎…The sustainability of the NHS is an absolute priority for the government. We could not agree to any proposals on medicines pricing or access that would put NHS finances at risk or reduce clinician and patient choice.”

 

TRUMP’S PLAN FOR THE NHS: CHANNEL 4 DISPATCHES: Mon 28th Oct, 8pm, Channel 4

Reporter: Antony Barnett

Exec Producer: Eamonn Matthews

Producer: Monika Ghosh

Dirs/Prods: Flora Bagenal, Alasdair Glennie, Edward Hancox

Production Company: Quicksilver