Our NHS – American Patients First?

During his presidential campaign, Donald Trump promised his voters that he would bring down the cost of their drugs, a source of constant anxiety for working Americans thanks to their fragmented Health Insurance based system.  During 2018 there were various reports criticising Mr Trump for having failed to meet that pledge.  Associated Press reported that in an analysis they had done, there had been more price hikes than drops i.e. for the pharma industry it was business as usual.

Johnson, Trump and the NHS
Johnson, Trump and the NHS

In May 2018, Alex Azar, Mr. Trump’s health secretary, declared that Washington would address this matter by pushing up drug prices in their overseas markets in order to push down the prices for the domestic market.  Getting better margins overseas for the pharma industry would give Trump leverage with the drug companies so he could do a deal with them.  Mr Azar told CNBC “On the foreign side, we need to, through our trade negotiations and agreements, pressure them.

And so we pay less, they pay more “. He went on: “The reason why they are getting better net prices than we get is their socialised system.”

The Orange One himself has also spoken on this matter and is reported as saying

“America will not be cheated any longer, and especially will not be cheated by foreign countries.  In some cases, 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 once and for all.”

How do you feel about the UK being called freeloaders, folks? 

So you see, when you examine the conversations that have been going on in US politics, it is no surprise when documents such as those revealed by the Labour Party this week, appear to show discussions  between the British Government and the US about the pricing of drugs and the very large NHS market which can be super lucrative with bigger margins and longer patents.  Drugs in the US are roughly 2 and a half to 10 times more expensive than in the UK depending on the product, so you can imagine that removing price controls in the UK would be a tasty carrot dangled by Trump to the US Pharma industry. 

The papers containing minutes of meetings about trade show that the Trump administration want the British government to dismantle the safeguards that protect the NHS from paying high prices for drugs.  They have discussed “full market access” for US drugs and prices to be “market derived” ending the ability of our own body, the National Institute of Health and Care Excellence (Nice) to cap prices as it currently does.  The US administration also want longer patents so reducing the ability of Nice to switch the NHS to generic drugs away from the branded versions as quickly.

Even without these documents, just applying logic and business common sense, we will be outside the EU and therefore a Third country which must negotiate many trade agreements if we are ever to rebuild our economy.  The US, Trump or not, though Trump makes it even worse, will attempt to use whatever it can to take advantage of that to the benefit of their own voters.  Remember Trump’s cry is Make American Great Again. 

make brexit stop

Well in the world of Trump, he is not going to do that by standing back and not throwing his weight around to make the most outrageous demands on our drug pricing controls and some of those demands will stick because we will be very keen to do a trade deal quickly and we will have to give something away, which is presumably why these meetings with the Trump administration have been taking place since 2017.

Why are drug prices important?  Well it’s obvious really.  If our drugs cost more, our healthcare cost goes up and we must either find extra funding or we must cut back on the extent and range of treatments available on the NHS.  There is often an accusation that we already have a two-tier system.  Well if Trump gets his way, you ain’t seen nothing yet.   If you voted leave because you believed that it would enable the UK to take back control, I am sorry to tell you that this is yet another area where that won’t happen.  We will be the weaker player in any negotiation.  It’s all very well for Johnson to say now that he won’t negotiate on our drugs market, but in the real world the US will want that on the table, and they will insist on talking about it.  We should have learned by now after 3 years of negotiations with the EU just on the terms of our withdrawal that negotiating is a tough business and a two-way street.  None of the leave cherry picking promises have been achieved with the EU, what makes us think we will fare better in dealing with the might giants of the Washington.

All I can tell you is that If you are sick of Brexit, you had best hope you don’t get sick after Brexit if Johnson and Trump each get their way. Or you can use your vote in this election to send a signal that you don’t want their way.

You can read more from the author of this post, Pilar, at her website or on Twitter (@redalphababe)