US threatens to use trade talks to force NHS to pay more for drugs

DONALD TRUMP is preparing to use trade talks to force the NHS to pay more for its drugs.

As part of his scheme to “put America first”, Mr Trump says high costs facing US patients were a direct result of other countries’ health services “freeloading” at America’s expense.

Alex Azar, the US health services secretary, said Washington would use its muscle to push up drug prices abroad to lower the cost for patients at home.

“We need, through our trade negotiations and agreements, to pressure them so we pay less and they pay more. It shouldn’t be a one-way ratchet. We all have some skin in this game,” Mr Azar said, adding that services like the NHS paid lower prices than the US because of their “socialised system”.

In the UK, prices are set in part by the National Institute for Health and Care Excellence, which secures significant discounts for some of the costliest drugs. Government-run single-payer health services like the NHS are able to use their negotiating muscle to pay far lower prices than the fragmented insurance-based private American counterpart, to the fury of the US president.

Mr Trump said: “America will not be cheated any longer, and especially will not be cheated by foreign countries.”

He added: “Medicine that costs a few dollars in a foreign country costs hundreds of dollars in America – for the same pill, with the same ingredients, in the same package, made in the same plant. That is unacceptable. It’s unfair. It’s ridiculous. It’s not going to happen any longer. It’s time to end the global freeloading.”

But Democrats accused Mr Trump of looking after big business rather than patients. Pharmaceutical giants in the US are among the biggest corporate political donors. Lowering drug prices was a key campaign pledge and Mr Trump aims to achieve it by making other countries pay more.

“This applies to all advanced countries, including the UK,” said Paul Ginsburg, professor of health policy at the University of Southern California.

Brandon Barford, a policy adviser, said: “This effort to change other nations’ health policies will be driven… when negotiating deals to avoid application of US tariffs or, in the case of the UK, a bilateral trade deal post-brexit.

“The second goal is that, for the UK in particular, trade negotiations will occur in the run-up to the US Presidential election in November 2020. The President and his team want to be able to use the NHS and Nice as a foil for his plan that reduces costs for consumers at the point of sale, but without rationing and access restrictions for which the UK system is infamous in the US, particularly among conservative media.”

Britain’s lower drug prices date back to a 1957 agreement designed to “achieve a financial balance in the interests of patients, the NHS, taxpayers, and the pharmaceutical industry”.

While prices in the UK are controlled, in the US they are left to the market and the differences can be dramatic.

“How much the UK spends on healthcare and on medicines is a matter for the UK government and it is not clear to us how the US would influence this,” said Richard Torbett of the Association of the British Pharmaceutical Industry.

Nigel Edwards, of the Nuffield Trust, blamed the absence of a single largescale negotiation by the US government. “This is more likely to be the cause of high drugs pricing, rather than one side of the Atlantic subsidising the other,” he said.