In December 2025, the UK and the US announced a new pharmaceutical agreement under the UK–US Economic Prosperity Deal, aligning trade policy with reforms to the UK’s medicines pricing and access framework.

The agreement combines concessions from both parties – the principal concessions from the US are a three-year commitment to zero tariffs on UK-made pharmaceuticals, and a promise of no new US trade action on UK drug pricing practices.

The principal concessions from the UK include lower and capped rebate payments under the UK’s branded medicines pricing scheme (VPAG), higher cost-effectiveness thresholds for medicines funded on the UK National Health Service (NHS), and a clear government commitment to increase NHS spending on innovative medicines. While the agreement does not resolve all the UK’s long-standing structural challenges, it represents a meaningful step toward rebuilding confidence in the UK life sciences sector supporting the UK’s global competitiveness.

In this whitepaper, Marwood examines the key elements of the UK–US medicines agreement and assesses their implications for pharma and biotech companies, including how improved trade certainty, more sustainable rebate levels, and higher NICE thresholds could make UK launches more viable, enhance revenue visibility, and encourage renewed investment in the UK market.