Campaigners challenge Trump’s NHS drug price rip-off

Patient-led campaign group Just Treatment and social justice organisation Global Justice Now have written to the UK government setting out why they believe it has acted unlawfully in pushing through changes to NHS drug price control frameworks. It’s the first stage of a legal challenge to a central pillar of the US-UK trade deal on pharmaceuticals.

A statutory instrument, which passed into law in April, gives ministers direct control over the key cost effectiveness threshold NICE uses to determine which medicines are routinely available on the NHS.

Trade deal impacts NHS drug price structure

The government needed this change to deliver on the promises it made to Donald Trump under the December 2025 trade deal on pharmaceuticals. It’s part of a package of changes that commits the UK to increasing NHS spending dramatically on patented medicines over the next 10 years.

But the letter (available here) sets out why the changes are unlawful. And it asks the government to revoke the legislation or face a court battle on the changes.

The claimants believe that the changes effectively end NICE’s independence from political interference, leaving medicine prices subject to political lobbying by Big Pharma corporations and the US government.

They say this poses an existential risk to the UK’s careful framework of safeguards designed to protect patients and the NHS from the excessive pricing demands of the industry. Changes the government has committed to under the Trump deal are estimated to cost the NHS billions of pounds a year by 2035, and have been widely criticised by health experts.

Diarmaid McDonald, director of Just Treatment, said:

The government caved in to threats from Donald Trump and the pharmaceutical industry and signed a deal that experts say could cost the lives of over 300,000 NHS patients. That’s more excess deaths than COVID.

Worse still, they’ve refused to publish their own assessments of the damage the deal will do to the NHS, and they’ve used a parliamentary process designed to make it extremely difficult for MPs to properly scrutinise what they are up to.

But we believe the process they have followed is unlawful, and we are ready to take them to court to defend NHS patients and our democracy.

Nick Dearden, Director of Global Justice Now said:

The government has tried to claim this is about improving outcomes for patients and accelerating access to medicines, but everyone knows this is a move forced on the government by Donald Trump and Big Pharma.

This is a government gambling with NHS patients’ lives in a geo-political game with Donald Trump. They risk sabotaging our carefully worked out mechanism for keeping a lid on Big Pharma’s overinflated prices, and they have done so without so much as a debate in parliament.

Rowan Smith, lawyer at Leigh Day, said:

Our clients are deeply concerned about the impact the UK’s pharmaceuticals trade deal with the US could have on the price and availability of drugs and medicines.

They argue that new powers giving the health secretary direction over NICE in matters regarding cost effectiveness risk undermining an important and globally recognised health body, and could materially impact what drugs and medicines are available on the NHS.

In submitting this legal letter, our client hopes that the health secretary will consider revoking the new regulations enforcing this change.

Politicians across the board raising concerns

Parliamentarians have been trying to force a public debate on these changes, but the mechanism the government used to enact them, known as a negative statutory instrument, makes that kind of independent scrutiny almost impossible.

Nonetheless MPs and peers from Labour, Conservatives, SNP, Lib Dems, Greens, and Plaid Cymru, as well as two cross-party committees, have raised concerns.

NICE should be independent of ministerial control, but the deal the UK signed with Trump included commitments to increase the cost-effectiveness thresholds it uses to determine if medicines are good value for money and so available for use on the NHS.

That required the government to legislate to give itself the power to force that change on NICE, and it has already used it to adjust the thresholds. But the letter asserts that the intention of the changes directly contradicts the primary legislation being amended and therefore should only be made using a new primary legislative process.

John McDonnell MP has been leading parliamentary efforts to secure scrutiny of the US-UK trade deal, and started a motion opposing the legislation enacting changes in NICE. He said:

The government has ridden roughshod over the democratic process, the views of MPs and Peers, and the lives of NHS patients to force through a deal with Trump that they claim is in the interests of the UK.

But they won’t publish anything to evidence their claims, and they won’t enable time for proper parliamentary debate on this. It is an extremely dangerous precedent and I hope the government backs down or the courts re-establish the democratic principles our parliament relies upon.

The campaigners have set up a crowdfunder to cover the legal costs of the case, which needs to go to court within three months of the legislation coming before parliament.

Featured image via Alex Wong / Getty Images