Overview

• Officials have briefed the US on plans to lift the cost‑effectiveness threshold used by NICE by about 25%, and the government says discussions are at an advanced stage.
• Acceptance by the US has not been confirmed; Trump has threatened tariffs of up to 100% on pharmaceutical imports unless other countries pay more for drugs.
• The move would shift the current £20,000–£30,000 per QALY range toward roughly £25,000–£35,000, easing approvals of costlier treatments and raising overall medicine spending.
• A Whitehall dispute has opened over funding, with Chancellor Rachel Reeves resisting new cash and Health Secretary Wes Streeting pushing for departmental support beyond the NHS budget.
• Experts including the Nuffield Trust warn the change could cost billions and harm population health by diverting resources, while advocates say access to some cancer and weight‑loss medicines could expand.