Global turmoil increases case for EU / UK alignment on medicines security

“Stability isn’t nearly so spectacular as instability,” pointed out Aldous Huxley. And, of course, global instability is no longer a distant geopolitical concern – it is now affecting NHS patients directly. Recent US foreign policy decisions, particularly those that have intensified tensions in Iran and across the Middle East, have sent shockwaves through global supply chains. Those ripples are now reaching the UK’s medicine cabinets, and the NHS is a few weeks away from potential shortages.

Off‑patent generic and biosimilar medicines are essential to the safety and sustainability of the NHS, accounting for 85% of all prescriptions in hospitals and community pharmacies. They are the everyday treatments that keep the health service running – from cancer and cardiac care to mental health and HRT.

These medicines only exist because, once patent protection ends, competition enters the market. Companies compete primarily on price, delivering more than £20 billion in annual savings and ensuring the UK continues to benefit from some of the lowest medicine prices in Europe.

But this model is built on high volumes and razor‑thin margins. Any disruption – whether political, economic or logistical – can quickly become difficult to absorb. The very efficiency that makes the system affordable also makes it fragile. Only a quarter of the medicines used by the NHS are manufactured in the UK; the rest come largely from Europe and India, supported by supply chains that stretch deep into China.

Record‑low UK prices have left almost no room for resilience. The volatility triggered by the Iran crisis has pushed up transport and energy costs dramatically. These pressures cannot be absorbed indefinitely. The result will be shortages, price rises – or both.

The uncomfortable truth is that the UK’s Life Sciences Sector Plan has not prepared us for this moment. The government’s plan lacks a serious strategy to secure the supply of essential medicines, and we are falling behind countries that have taken stronger action. The European Union is close to finalising its Critical Medicines Act, years in the making, to strengthen resilience across the continent.

Meanwhile, the UK has been drawn into a different kind of pressure from the United States. Tariff threats and investment stand‑offs have pushed the Government toward commitments that favour US pharmaceutical interests – potentially adding billions of pounds to the UK’s branded medicines bill. That money will almost certainly come from existing healthcare budgets. Yet almost nothing has been invested in securing the essential off‑patent medicines that patients depend on every day. Two new antibiotic manufacturing facilities could be built in the UK for a fraction of what is being committed elsewhere to appease US investors and shareholders. One of last remaining antibiotic manufacturing plants in England closed last year.

Sir Keir Starmer has emphasised the need for a closer relationship with the EU, and the next UK-EU summit, set for later this year, is the point on the horizon when new forms of cooperation could be committed to. Defence and security will be central to those talks – and medicines security must be part of that conversation.

There are clear areas of mutual benefit for both sides when it comes to medicines supply, and the EU and the UK are not just geographically closer than other potential allies. There is greater political alignment than with many other administrations.

Mutual recognition of batch testing needs to be addressed, and it is a clear example of where greater collaboration can take place. Products made in the EU can be imported to the UK, but not vice-versa. This is directing investment decisions and creating an unbalanced supply chain. In a crisis, EU countries could benefit significantly from UK-made products, and the region doesn’t have the capacity to produce all the medicines it needs.

The EU’s Critical Medicines Act is another area for review and potential partnership. The current version allows member states to preferentially purchase products made on the continent. For critical products in short supply, we believe the UK should be on the same footing as EFTA countries in being allowed to participate in and benefit from the provisions of the Critical Medicines Act. It makes mutual sense for countries to work together on this.

Elsewhere, via the Life Sciences Innovative Manufacturing Innovation Fund (LSIMF), the UK already has dedicated funding for medicines production, with resilience as one of its goals. But the fund suffers from competing objectives and oversight by three separate government departments, which reduces its focus on resilience.

Given the increasingly stretched nature of supply chains, the UK and EU should coordinate on or at least be aware of how this money is being allocated. There is little point in duplicating efforts to reshore key supply chain elements when partnering could create a more cohesive, powerful shared supply chain with greater capacity for both sides when needed most. The EU and UK could explore how UK packs could be supplied to Europe’s other English-speaking markets, including Ireland, Malta and Cyprus, thereby providing patients in these countries with more choice and greater stock capacity.

The UK and EU need a shared plan to ensure patients can access essential treatments in times of global turmoil. Without it, the next geopolitical shock will not just be a foreign policy crisis. It will be a public health one.

By Mark Samuels, chief executive, Medicines UK