Fix the NHS or miss out on our money, US drug giant warns Britain

Sir Keir Starmer must urgently address problems with the NHS or risk missing out on future investment in Britain, the UK boss of drug giant Eli Lilly has warned.

Chris Stokes, the managing director of the obesity jab maker in the UK, said there needed to be a greater “sense of urgency” in addressing issues such as the slow pace at which drugs are rolled out to NHS patients and discontent over industry-funded subsidies for the health service.

Without action, Mr Stokes said Eli Lilly was unwilling to commit to new investment in the UK.

Mr Stokes said: “We’ve stepped up, we’ve made a pledge, we’ve made our intention known and we’re going to continue to work on it but we do want to see some things addressed before we make any other further commitments.”

Eli Lilly was among the companies showcased by the Prime Minister at the International Investment Summit in October. The US drug maker announced a £279m investment in the UK as part of a tie-up with the Government that included working together on weight-loss jabs.

Eli Lilly is the developer of Mounjaro, a treatment dubbed the “King Kong” of weight-loss jabs because of its success it helping people slim down.

At the summit, ministers vowed to speed up how quickly drugs could get to patients on the NHS and rip up bureaucracy for businesses.

Mr Stokes said: “It’s a great message, but let’s look at some tangible examples of that between that point and today. There aren’t many.”

While Mr Stokes was clear that Eli Lilly’s £279m investment was not at risk, he said the Government needed to do more to address the drug makers concerns before it could commit to further spending in Britain.

Mr Stokes said ministers “point blank” needed to be more proactive in delivering on promises to speed up access to drugs and address the issue of rising NHS rebates.

“We do want to see those two things addressed [by the Government] before we make any further broader decisions. I’m not going to commit on more or less [investment], but I do think that we need to look at that now.”

Historically Eli Lilly has invested in other countries, such as Ireland, at double the rate at which it’s backed the UK. The company unveiled a $27bn (£21bn) investment in the US in February.

Frustration is rising after the NHS spending watchdog last December said it would limit the roll-out of Mounjaro. While the National Institute for Health and Care Excellence (Nice) recommended the treatment for people with a BMI of at least 35 and at least one weight-related health condition, it said the treatment would be restricted.

Only 220,000 NHS patients will be prioritised for the jabs over the next three years. Eli Lilly argues that this would mean is just 11 people at each GP surgery would be able to access the treatment each year. Around 90pc of eligible obese patients would not be able to get the jab on the NHS.

Nice has claimed its decision was made “in order to protect other vital NHS services” after healthcare chiefs warned they needed a slow rollout to set-up new services and train staff up to monitor patients on the jab.

Still, it has been a source of much frustration within Eli Lilly, which says it is still waiting for details on which patients should be prioritised. The list was meant to be published in January.

Eli Lilly has argued the potential benefit to rolling out its weight-loss treatment could be significant. Trial data show that Mounjaro can help people lose an average of 3.5 stones (22.8kg) over 72 weeks.

“I get that there are many challenges with the NHS,” said Mr Stokes. “We completely understand that. But the urgency of this challenge is significant. The annual cost to the NHS [of obesity] is estimated to be around £11.4bn. The NHS, in my opinion, can’t afford not to solve that challenge. We think there’s a real opportunity to handle this one quickly.”

Cynics may argue Mr Stokes is pushing for a quicker rollout only to benefit Eli Lilly. Yet he insisted the company was “trying to be part of the solution”.

Under the tie-up announced with the Government last October, the US drug maker is conducting a five-year clinical trial which will assess the “real-world effectiveness” of Mounjaro including its impact on worklessness and productivity.

Wes Streeting, the Health Secretary, has said weight-loss treatments could have a “monumental” impact on obesity and get Britain back working.

Mr Stokes claimed that the Nice decision risked creating more societal problems. It threatens to widen health inequalities, he argued, as there is a “higher prevalence of obesity in the most deprived areas”. These people are less likely to be able to buy Mounjaro privately, as a month’s supply of the treatment costs around £215.

“We do need some urgent action from this Government and those numbers [of NHS patients who will get access to the jab], it’s just too slow.”

There are other areas where Mr Stokes said the Government is falling short. Like others in the sector, Eli Lilly is concerned about the rapidly rising cost of NHS sales rebates.

Companies sign up to a voluntary scheme to avoid paying high levies on drugs sold to the NHS. The rebate scheme caps the increase in the NHS’s bill for branded drugs to a certain percentage each year. If the bill rises above the cap, then drug makers have to compensate the health service in the form of rebates.

A surge in ill health since the pandemic has led the NHS’s branded drugs bill to balloon – and landed drug-makers will huge rebate costs in the process. This year, drug companies are expected to pay back an eye-watering £3.6bn, compared to around £600,000 every year between 2014 and 2021. Eli Lilly quit the voluntary scheme in protest at the rising bill in early 2023, though it has since rejoined.

Mr Stokes said the rebate scheme was a symptom of the misguided focus on simple costs within the NHS rather than “evaluating a drug’s complete social and economic value”.

“We think that this is a conversation that really needs to happen.”

He was speaking before Sir Keir announced plans to abolish NHS England, the quango that manages the health service, as part of efforts to strip out bureaucracy.

NHS England will be folded into the Department for Health and Social Care in a process expected to take “around two years”. While exact details of the changes are yet to be announced, the move is not expected to have any immediate impact on how drugmakers deal with the health service.

Responding to the announcement, Mr Stokes said Eli Lilly was “encouraged the Government stated one of its aims was to improve partnership between the NHS and industry”.

However, he added: “It’s important that these changes do not distract from the vital work of improving care for patients in the UK. For example, that it does not delay the NHS publishing its rollout plan which is already overdue.”

A government spokesman said ministers wanted to “foster a strong life sciences sector with cutting-edge technology and artificial intelligence to provide high-quality care for all”.

They added: “Through our plan for change we will grow the economy, create jobs and reform the NHS – building on the UK’s position as the second-most attractive destination for international investment.

“Obesity drugs can be life-changing when used responsibly with diet and exercise. NHS England’s phased rollout prioritises those in greatest need while managing pressures on the health service.”

Mr Stokes took over as Eli Lilly’s president and general manager of UK, Ireland and Northern Europe in July, the same month that Labour came to power. He previously steered Eli Lilly’s South Korea business and its South African office.

The American said he was “a newcomer to a degree – although I’ve been at the company for just about 17 years”.

He is approaching Britain “with a different lens”, he said.

“I would love this Government to really walk the talk. That is my call to action.”