Campaigners file legal challenge to ‘unlawful powergrab’ over NHS drug price controls

A legal battle by campaigners against the UK government over changes it has made to the UK’s drug price control system is moving to the courts, following a formal exchange with the government’s lawyers.

In its response to a pre-action letter, the government sought to justify the way changes, which will end the independence of NICE (National Institute for Health and Care Excellence) from ministerial control, have been made.

But the campaigners and their lawyers remain convinced it has acted unlawfully and have moved to get court permission for a full judicial review.

Patient-led campaign group Just Treatment, and social justice organisation, Global Justice Now, are taking the government to court, alongside their lawyers, Leigh Day, over the introduction of new regulations used to enact a central pillar of the US-UK trade deal on pharmaceuticals. The groups are crowdfunding to see the case through and cover the full legal and court costs.

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 made routinely available on the NHS.

Dancing to Trump’s tune

This change was required to enable the government to deliver on the promises made to Donald Trump under the trade deal on pharmaceuticals announced in December 2025.

It is part of a package of changes that commits the UK to dramatically increasing spending on patented medicines by the NHS over the next ten years.

But in a letter to the government (available here) last month campaigners set out why the changes are unlawful, and asked the government to revoke the legislation or face a court battle on the changes.

The campaigners believe that the changes effectively end NICE’s independence from political interference, leaving drug price setting 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.

In its response the government stuck firm to its view that it has acted lawfully. Campaigners and their lawyers have now filed papers with the courts, seeking permission to have a court hearing so a judge can rule on the matter.

Diarmaid McDonald, director of Just Treatment, said:

It is extremely disappointing, but sadly not surprising, that the government has refused to admit the mistake they made in trying to bypass parliamentary scrutiny in order to push these changes through.

Throughout this process the government has listened to the US government and drug company lobbyists instead of NHS patients, staff, MPs, or independent experts.

We can’t allow them to put so many lives, and our publicly funded health system, at risk to inflate industry’s profits and Trump’s ego.

While we hope the courts force the government to reverse this unlawful and undemocratic change, the entire deal requires much greater interrogation.

When this deal places so many lives at risk we have to ask why the demands of the pharmaceutical industry were met, and what the implications of their monopoly power are for our democracy, economy, and health.

Nick Dearden, director of Global Justice Now, said:

The government has shown it won’t stand up to Trump in order to protect our NHS, so we are taking matters into our own hands.

We won’t stand by and allow the NHS to be weakened simply in order to further inflate the profits of an industry that cares more about the interests of their shareholders than those of ordinary people.

The government has pushed through these measures without so much as a debate in parliament: so we are left with no other choice but to fight this in the courts.

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.

Drug price setting tied up in legislative knots

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, is designed to make 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 was established to 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 deemed to be good value for money and so made 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 legal filing 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.

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