Six UK parliamentary committee chairs have written to the National Audit Office calling for a rapid investigation into the cost of the UK-US drug pricing deal, after the government refused to publish full details of how much the agreement will cost the NHS.
In their letter, sent on Wednesday, the lawmakers argued there is significant public interest in understanding the deal's implications for public expenditure. They formally requested that the National Audit Office undertake a rapid investigation into the costs of the arrangement and assess whether it represents value for money for the taxpayer.
The deal in question was agreed in December of last year, with the UK committing to increase spending on new medicines in exchange for three years of zero tariffs from the United States on pharmaceutical products. As part of the agreement, the UK government committed to doubling its pharmaceutical spending to 0.6 per cent of GDP by 2035. It also laid secondary legislation updating the rules governing the National Institute for Health and Care Excellence, allowing the body to raise its cost effectiveness threshold, the point at which a medicine is judged to offer sufficient value for money, by 25 per cent.
The committee chairs argued that without a comprehensive impact assessment covering future years, Parliament and the public remain unable to fully understand the long term implications of the agreement for NHS budgets and wider public expenditure.
The government has so far declined to publish the full projected cost of the deal to the NHS. It has instead estimated that the agreement will cost approximately £1 billion over the current spending review period, a figure the letter's signatories suggest may not capture the full financial picture.
Sally Gainsbury, senior policy analyst at the independent health think tank the Nuffield Trust, had previously sought access to the government's impact assessment of the deal but was refused. The Information Commissioner's Office found that the Department of Health and Social Care had argued releasing the assessment would prejudice ongoing policy development, international relations and commercial interests.
Gainsbury subsequently launched an appeal to the Information Tribunal on 17 August over the government's decision to withhold the assessment. The case is due to be heard between December and February.
Commenting on the deal, Gainsbury said it would have a significant negative impact on the NHS's ability to improve the health of the population, arguing that it would divert resources away from more cost effective forms of care and towards more expensive, and often less certain, treatments.
She said the government had justified the deal as necessary to support economic growth, but had not been willing to reveal the details of its own assessment supporting that claim. She added that transparency on an issue of this significance should not require legal action, and welcomed the intervention of the six parliamentary committee chairs as evidence of the strength of public interest in the matter, expressing hope that the government would respond accordingly.
The letter was signed by Health and Social Committee Chair Layla Moran, Science, Innovation and Technology Committee Chair Chi Onwurah, Business and Trade Committee Chair Liam Byrne, Northern Ireland Affairs Committee Chair Tonia Antoniazzi, Scottish Affairs Committee Chair Patricia Ferguson, and Welsh Affairs Committee Chair Ruth Jones.
The National Audit Office has not yet indicated whether it will proceed with an investigation into the deal's costs. The outcome of Gainsbury's tribunal case, expected to be heard between December and February, may also shed further light on the government's own assessment of the agreement's long term financial implications for the NHS.
