UK health campaigners threaten legal action over US drug pricing deal

LONDON — Health campaigners are threatening to bring the British government to court over its drug-pricing deal with Donald Trump, in a legal fight that risks undermining a key pillar of the U.S.-U.K. trade deal.

Patient advocacy group Just Treatment and social justice organization Global Justice Now have written to the new Health Secretary James Murray, accusing ministers of breaching parliamentary protocol as they rewrite NHS drug-pricing rules to meet Washington’s demands.

Last month, a regulation handing the health secretary new powers to direct NHS spending on medicines was quietly passed into law, in a bid to fulfill commitments made to the Trump administration to raise the U.K.'s cost-effectiveness threshold for drugs.

The groups are demanding the government revoke the legislation or face a court battle. They are concerned the changes risk opening the door to greater influence from pharmaceutical companies and U.S. officials over how NHS money is spent.

Just Treatment Director Diarmaid McDonald said: “[Government have] refused to publish their own assessments of the damage the deal will do to the NHS, and they’ve used a parliamentary process designed to make it extremely difficult for MPs to properly scrutinize what they are up to.”

“But we believe the process they have followed is unlawful, and we are ready to take them to court to defend NHS patients and our democracy,” he added.

The deal

In December, Britain struck a deal with the Trump administration, promising to increase NHS spending on new medicines in exchange for tariff-free access to the American pharmaceutical market for at least three years.

The deal included a 25 percent increase to the threshold used by the National Institute for Health and Care Excellence (NICE) to determine whether drugs offer good value for money should be made available on the NHS.

The legal challenge argues that the government crossed a constitutional line by giving ministers powers to direct NICE — which was originally set up to make independent decisions free from political control.

Campaigners believe such a fundamental change to how NICE functions should have required primary legislation, rather than secondary legislation pushed through with limited scrutiny.

Some MPs have already tried to push back on the legislative changes.

Former Shadow Chancellor John McDonnell led a cross-party intervention, writing to former Health Secretary Wes Streeting to publish the government’s impact assessment of the deal and allow MPs to debate it in parliament.

The letter, seen by POLITICO, was signed by more than 20 MPs, including former Green party leaders Siân Berry, Carla Denyer, Adrian Ramsay, Green MP Hannah Spencer, Labour MP Andy McDonald and SNP MP Seamus Logan.

“We are deeply concerned that the government is going against its promise to keep the NHS off the table in a trade deal with Trump,” the letter stated. “This agreement will likely have a huge impact on our health services, especially if it means diverting funding from our parts of the NHS.”

What’s next?

Nick Dearden, director of Global Justice Now, said the government is expected to respond “within days.”

“As soon as the government gets back to us, we’ll consider what they say and if they produce any more information [on the deal] or if they’re going to change the process in any way,” he said. “If not, we will then look to proceed to judicial review, which challenges the way they made this decision.”

If the challenge proceeds, a court would examine whether ministers acted lawfully in using secondary legislation to alter NICE’s powers. A ruling against the government could force ministers back to parliament to pass primary legislation — opening the door to a political battle over whether Labour traded away the NHS for closer ties with the U.S. president.

“I would suggest that a different way would involve far more parliamentary scrutiny and accountability then there’s been today,” said Dearden. “It may well be that the government, even with a large majority, would struggle to get that through.”