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The chairs of six parliamentary committees have asked the National Audit Office (NAO) to look into whether the pharmaceutical pricing agreement between the UK and the United States offers value for money.
In a letter sent to the NAO on 15 September 2026, the parliamentary committee chairs wrote that “without a comprehensive impact assessment covering future years”, both Parliament and the public will be unable to fully grasp the long-term implications of the arrangement on NHS budgets and public expenditure.
The House of Commons Health and Social Care Committee — one of the six parliamentary committees whose chair co-signed the letter — had repeatedly requested publication of the impact assessment of the agreement, “to enable appropriate parliamentary scrutiny”, but that to date, the information had not been made public, the letter added.
The pharmaceutical deal between the UK and the United States, announced in December 2025, was described by the government at the time as a “landmark” deal that would “secure and expand access to vital drugs, safeguard our medicines supply chain and drive crucial investment while supporting UK patients and industries”.
Under the deal, the US government committed to imposing no tariffs on UK pharmaceutical products shipped to the United States between 1 January 2026 and 19 January 2029. It also expects pharmaceutical companies to continue to launch new medicines in the UK.
For its part, the UK government committed to increasing the cost-effectiveness thresholds used by the National Institute for Health and Care Excellence (NICE), adding that it would invest around 25% more funding into innovative treatments.
In a press release published on 17 September 2026, NICE highlighted that it approved breast cancer drug Enhertu (Trastuzumab deruxtecan; Daiichi Sankyo) for use on the NHS, after initially rejecting it in 2024.
A commercial solution had been agreed for NHS use in England, following changes made to its evaluation methods as part of the UK–US pharmaceutical deal, it added.
However, at the time the deal was announced, Sally Gainsbury, senior policy analyst at health think tank The Nuffield Trust, said: “A big increase in the price the NHS pays by raising the NICE threshold will not bring additional benefits for the population as a whole, it will just make healthcare more expensive.
“The NHS budget is already under intense pressure and so the reported £3bn extra cost will need to be fully funded by the Treasury.”
The joint letter also noted: “Given the potentially significant financial implications of this agreement, and the fact that attempts by parliamentary committees, including the Health and Social Care Committee and the Science, Innovation and Technology Committee, to obtain further information from the department have not been successful, we would like to formally request that the NAO undertake a rapid investigation into the costs of the arrangement and assess whether it represents value for money for the taxpayer.”
A spokesperson for the NAO told The Pharmaceutical Journal on 18 September 2026: “The comptroller and auditor general has received the request and will consider it carefully in determining the NAO’s work programme.”
The six House of Commons committee chairs who co-signed the letter are:
- Layla Moran MP, chair of the Health and Social Care Committee;
- Dame Chi Onwurah MP, chair of the Science, Innovation and Technology Committee;
- Liam Byrne MP, chair of the Business and Trade Committee;
- Tonia Antoniazzi MP, chair of the Northern Ireland Affairs Committee;
- Patricia Ferguson MP, chair of the Scottish Affairs Committee;
- Ruth Jones MP, chair of the Welsh Affairs Committee.
