The UK Medicine Payment Rates for pharmaceuticals, stipulated under the Voluntary Scheme for Branded Medicines Pricing, Access, and Growth (VPAG), have reached an alarming 23.5% in 2025. This policy, intended to limit NHS spending on branded medicines, has diminished the UK’s appeal for life sciences investments. The effects include reduced R&D expenditure, delayed medicine launches, and workforce reductions. Survey data from 33 companies indicate that 19% foresee cuts to R&D due to the 2025 rate. Between 2023 and 2025, 15 new active substances and 38 new indications were not launched in the UK. However, reducing payment rates below 10% could unlock £10.9 billion for R&D by 2033, generate £61 billion in GDP over 30 years, and restore the UK’s competitive edge.

Understanding VPAG’s Structure and Purpose

Framework and Goals of VPAG

The VPAG agreement, effective from 2024 until 2028, strives to balance NHS affordability, patient access, and industry growth. It caps annual branded medicine sales growth at 2%, with any excess subject to a repayment levy. While similar to earlier schemes like VPAS (2019–2023), VPAG’s dynamic repayment mechanism has led to unprecedented payment rates due to higher-than-expected medicine use post-pandemic. The UK Medicine Payment Rates for 2025 stand at 23.5%, outpacing rates in France (5.7%), Italy (6.8%), and Germany (7%).

Key Insights from the ABPI Report

Declining Competitiveness on the World Stage

• Impact on R&D Investments: The UK’s portion of global pharmaceutical R&D decreased from 4.1% in 2022 to 3.7% in 2023. This correlates with VPAS rate increases from 5.1% (2021) to 26.5% (2023).
• Delayed Medicine Launches: Only 13% of companies consider the UK a top-three priority for launches in 2025, down from 30% in 2022. High repayment rates have made the UK unfeasible for 27% of anticipated launches.
• Workforce Reduction: In 2024, 45% of companies reported workforce cuts, with an 8% decline projected by 2028 if rates stay above 20%.

Economic Benefits of Adjusting Payment Rates

• Recovery in R&D Funding: Lowering rates below 10% could restore £3.4 billion in R&D funding by 2028 and £7.5 billion by 2033. Rates above 30% would cut R&D activities by 14%.
• Impact on GDP and Tax Revenue: Reducing payment rates could increase cumulative GDP by £61 billion and tax revenues by £20 billion over three decades. This exceeds temporary NHS savings from high levies.

Fiscal Healthcare Considerations and Policy Reforms

High repayment rates deter premium therapies, such as gene therapies like Hemgenix, priced at $3.5M. The UK risks a “two-tier” healthcare system where innovative therapies are only privately accessible.

The current VPAG framework undermines the UK’s life sciences sector, prioritizing short-term budgetary control over sustainable economic and health advancements. Lowering repayment rates to internationally competitive levels (below 10%) would counteract R&D declines, accelerate patient access, and strengthen the UK’s position in precision medicine. With global R&D investments surging—the UK must adapt policies to prevent irreversible damage to its life sciences landscape.