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Arthur Walsh, editor, P3pharmacy

Up to now, Britain has got off pretty lightly when it comes to Donald Trump’s disruptive agenda. The 10 per cent tariff on most UK goods is far below those imposed on other markets, and while he’s probably not a Labour man the US president seems happy to tone down the blitzkrieg scare tactics in his dealings with Number 10

But the impact of this one-of-a-kind premiership is bound to be felt everywhere – even  in those nations against whom he hasn’t declared an all-out trade war. We’ve recently had  concrete evidence of this with Eli Lilly announcing huge price hikes for its range of Mounjaro weight loss injections.  

Lilly said this was about bringing UK prices in line with other major European markets, which carries some weight (so to speak). 

But as the financial press reported, the man in the White House is another probable factor. Trump has spooked drugs companies with his talk of Europe’s ‘freeloader’ nations  securing medicines for their populations at prices so low that – in his view – it puts American patients at a disadvantage.

So Britain is exposed to Washington’s whims, even if indirectly. And long-held  assumptions could be questioned closer to home, too, as the UK pharmaceutical industry gets more forceful in challenging its financial arrangements with the Department of Health  and Social Care (DHSC).  

The Association of the British Pharmaceutical Industry (ABPI) recently walked away from  talks with health secretary Wes Streeting when the parties failed to agree changes to the  branded medicines pricing scheme known as VPAG. The ABPI wants the DHSC to slash the current VPAG rates that see pharma companies  pay the NHS upwards of 23 per cent of their branded medicine revenues.

Countries like Ireland and France ‘claw back’ much less from the sector (9 and 7.5 per cent respectively), the trade body claims as it pushes for the lines to be redrawn.  

“For too long, the UK has sought to be the place where innovation happens – but not the  place where it is used,” said ABPI chief executive Richard Torbett. “Without change, the UK  will continue to fall down international league tables for research, investment and patient access to medicines.”

Streeting accused the industry of being “shortsighted” and said it was “regrettable” that  government’s recommendations had not been accepted. The department says the scheme is  designed to balance two quite different priorities: promoting innovation and keeping NHS spending down.  

The two parties are locked in stalemate and juggling those objectives would appear to pose no less of a headache for policymakers. Could another Trump-like shock be coming down the road to shatter our business-as-usual assumptions?