US-UK drug deal could cause 229,000 excess NHS deaths by 2036, analysis says

BMJ study warns NHS diversion could worsen health inequalities

The US-UK trade deal agreed in December 2025 will require the National Health Service to divert billions of pounds from essential services to pay for more expensive new medicines, according to an analysis published in the British Medical Journal, which projects that the shift could cause 229,000 excess deaths in England by 2036.

The analysis found that the NHS will face an additional £44.7bn in costs by 2036 for new medicines under the trade terms. Without extra government funding, the health service will have to redirect money from other budget areas, cutting spending on services that maintain public health.

Ministers have defended the pact as a way to help British drug exports avoid US tariffs and improve patient access, the analysis noted. They described the agreement as beneficial for the UK pharmaceutical industry and for patients requiring advanced treatments.

Critics accused the Labour government of caving to pressure from President Donald Trump during the negotiations. The analysis warned that the diversion of NHS funds would degrade the health service’s capacity to provide routine care, leading to worse health outcomes and higher mortality.

The agreement allows the United Kingdom to avoid the 10–12.5% tariffs the US imposed on 60 nations earlier this year, but it ties that relief to commitments on drug pricing. The analysis also said the deal could exacerbate health inequalities across the country.