NHS could lose 10,000 staff to US-UK pharma deal, says think tank

The NHS could lose out on 10,000 new staff by 2028 as resources are diverted to fund the UK’s pharmaceuticals deal with the United States, analysis by the Nuffield Trust suggests.

The analysis, shared with Channel 4 News, warns the agreement signed last year by Sir Keir Starmer with Donald Trump — which committed the UK to spend more on American medicines in return for zero tariffs and better access to cutting-edge drugs — could pull funding away from the frontline. It also found that many US medicines remain so expensive that the NHS still cannot afford them even under the deal.

Under the agreement, announced in December 2025, the NICE cost-effectiveness threshold for new medicines rose from £20,000–£30,000 to £25,000–£35,000 per quality-adjusted life year from April 2026. NICE has since approved drugs it previously rejected, including Enhertu (trastuzumab deruxtecan) for HER2-low breast cancer, which it turned down in 2024 (The Pharmaceutical Journal).

The Office for Budget Responsibility has estimated the deal means a 25% rise in branded-medicine spending — £3.3bn between 2025/26 and 2028/29. The Nuffield Trust’s Sally Gainsbury has said “the reported £3bn extra cost will need to be fully funded by the Treasury”, warning it “will just make healthcare more expensive”.

Meanwhile, the chairs of six Commons committees wrote to the National Audit Office on 15 September 2026 asking it to urgently investigate whether the deal offers value for money for the taxpayer; the comptroller and auditor general has received the request.