US pharmaceutical companies, including Eli Lilly and Johnson & Johnson, are raising prices and reducing access, with Lilly's Mounjaro nearly tripling in price amid a global price war, which impacts affordability and access in the UK.

Industry leaders warn that delays in negotiations and reforms could harm the UK's healthcare competitiveness and patient outcomes, especially given high clawback rates and current reimbursement schemes.

Overall, the UK invests a smaller share of its healthcare budget in medicines compared to other countries, and many new medicines approved elsewhere are not available in the UK, further exacerbating access issues.

This underfunding has resulted in delayed research and development, reduced access to life-saving treatments, and worsened cancer survival rates, with industry executives warning that the UK's healthcare competitiveness is at risk.

Despite these efforts, disputes persist over the availability of certain drugs, such as the lung cancer drug Krazati and breast cancer drug Enhertu, which are approved elsewhere in Europe but remain unavailable on the NHS due to classification and pricing disagreements with NICE.

Other affected medications include Trodelvy and Reblozyl, with the NHS citing lack of submission or classification issues, further limiting treatment options for patients.

Pharmaceutical industry leaders, including representatives from AstraZeneca, Merck, and others, have criticized the UK NHS for underinvestment in medicines, arguing that this has led to patient suffering, drug shortages, and the withdrawal of significant investments from companies like AstraZeneca and Merck.

The UK government claims to have offered a substantial financial package—around £1 billion over three years—to improve access and affordability, and emphasizes ongoing efforts to prioritize cancer care through the national cancer plan.

Negotiations over drug pricing have stalled, with industry demands to reform NICE's cost-effectiveness thresholds and the VPAG scheme, risking withdrawal of investment and research collaborations if unresolved.

The government has acknowledged the frustration, noting that over 60 drugs have been unavailable in the UK over the past five years, partly due to outdated cost-effectiveness thresholds that haven't changed in over 25 years.

While the government claims to have offered a significant package, critics argue that negotiations have broken down, threatening further reductions in available treatments and research partnerships.