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The generic medicines market in the UK must not be hit by a decision to increase thresholds for drug recommendations by the National Institute for Health and Clinical Excellence (NICE), pharmacy stakeholders have said.
The call comes in a letter sent to Baroness Morris, chair of the House of Lords Public Services Committee, on 5 December 2025. It was co-signed by the Company Chemists’ Association, Community Pharmacy England, the Healthcare Distribution Association and Medicines UK.
“Following the recent UK–US agreement and the commitment to increase prices for new branded medicines, it is essential that these changes are not funded by further pressure on the generic medicines market,” it said, adding that generics account for four out of five NHS primary care prescriptions.
“For years, competitive procurement of medicines for the NHS by community pharmacies has driven the prices of generic medicines down. It is estimated that this model has saved the taxpayer billions of pounds.”
The letter highlighted that the reimbursement price for up to a month’s supply of more than 850 million generic medicine packs is 99p or less, which is unsustainable.
“With medicine prices now so low in the UK, several global manufacturers have prioritised other markets or withdrawn from the UK entirely,” the letter said.
“Concerningly, in some cases, this has caused entirely avoidable medicine shortages.”
The stakeholders also called for a review of the role of drug tariff pricing and retained margin, to reduce the number of medicines supplied to the NHS at a loss, as well as the creation of a procurement model “whereby all parts of the domestic supply chain can operate in a financially sustainable way”.
On 1 December 2025, NICE announced that the NHS in England could spend 25% more on new medicines under increased cost-effectiveness thresholds that will be used by the regulator.
NICE added that new thresholds will allow the NHS to spend £25,000 to £35,000 per quality adjusted life year gained by the use of a new drug, compared with the previous thresholds of between £20,000 and £30,000.
The House of Lords Public Services Committee’s inquiry into medicines security is currently looking into the causes of medicine shortages, as well as how to predict and prevent medicine supply issues.
Speaking at an evidence session held by the inquiry in October 2025, Keith Ridge, former chief pharmaceutical officer for England, raised concerns that there is no explicit government policy around the stockpiling of critical medicines.
