Pharma’s Brexit Route

After three and a half years of volatile discussions and debates around Brexit, the UK is finally set to leave the European Union, 10 months after the originally mooted date of March 29, 2019. Prime Minister Boris Johnson’s decisive win at the polls in December (on the back of a simplified “Get Brexit Done” manifesto) put paid to the longstanding efforts of political rivals and pressure groups to further delay the Brexit process (or indeed to cancel it altogether). Johnson’s Conservative Party now sits in Parliament with an 80-seat majority, clearing the way for the new leave date of Jan. 31.

While UK pharma has been generally resistant to Brexit, the Conservatives’ pro-industry election pledges were broadly welcomed. The Tories have promised to increase public research spending to 2.4% of GDP; continue to collaborate with the EU on scientific research; invest £3 billion into a National Skills Fund; and make the UK “the leading global hub for life sciences.” They have also pledged to revamp the Cancer Drugs Fund as the Innovative Medicines Fund-setting aside £500 million of the medicines budget to give patients quicker access to cutting-edge medicines for cancer, rare diseases, and autoimmune diseases-and establish a “Dementia Moonshot,” doubling the existing levels of dementia research funding and increasing the number of researchers in innovative techniques, such as advanced therapeutics and neuro-technologies.

Mike Thompson, chief executive of the Association of the British Pharmaceutical Industry (ABPI), praised the manifesto for putting forward “an ambitious agenda to strengthen our position and make sure NHS patients can get breakthrough medicines faster.”

What did not feature in the Tory manifesto, however, was drug pricing, and this subject caused a mini-storm in the run-up to the election when Labour Party leader Jeremy Corbyn sensationally announced to the press that he’d received 451 pages of leaked, unredacted minutes relating to official UK–US trade talks, which showed that the NHS would be “up for sale” in any post-Brexit trade deal between the two countries.

Closer examination of the documents revealed that most of the issues covered in the trade talks (which took place over a two-year period between July 2017 and July 2019) did not relate to healthcare, but they did point to US negotiators “pushing hard” for longer patent periods for US-produced drugs and angling for “full market access” for their drugs at “market-derived” or “competitive” prices.

The Guardian pulled no punches in reporting that “US pharmaceutical interests want the British government to dismantle the safeguards that protect the NHS from paying high prices for drugs.” It added that full market access for US drugs would “greatly limit” the ability of the National Institute for Health and Care Excellence

(NICE) to decide “which medicines patients can receive” and lead to the organization “being marginalized.” Johnson and his team responded by strenuously denying that the NHS would ever be “on the table.” Even President Trump tried to assuage concerns by saying, in his incomparable way, that the US wouldn’t be interested in buying the NHS if “it was handed to us on a silver platter.”

The trade-deal controversy seemed to blow over, in the mainstream media at least, in a couple of days. This might be quite remarkable at any other time, but such was the unpredictable and unprecedented nature of British politics in 2019. Since the election, however, Johnson seems to be sticking to his healthcare and pharma promises. The government has proposed enshrining in law a commitment to boost spending on NHS, which has gone some way to soothing concerns about opening it up to the US market. The government has also announced plans to fast-track new drugs, adopting a “streamlined, internationally competitive” process for drug approval.

These are early days, of course. Upon leaving the EU at the end of January, the UK enters a “transition period” that sees its existing relationship with the bloc continue until Dec. 31, 2020. This promises to be another intense period of negotiation, with healthcare never far from the top of the agenda.

Julian Upton is Pharm Exec’s European and Online Editor. He can be reached at jupton@mmhgroup.com