Health risks being forgotten in Brexit negotiations, potentially delaying the availability of new medicines and imposing large costs on manufacturers, public health leaders have warned.
“Healthcare does not seem to feature in the top priorities of negotiators,” said Johnson & Johnson’s Mark Lloyd Davies at an event of healthcare experts in Brussels on Wednesday (21 February).
“There is a default position that health is a national competence and that ‘we’ll sort it out later,’” he added.
Healthcare is usually among the most important policy issues to voters at national elections but has largely been absent from the Article 50 talks between the EU and UK.
That is despite the fact that the UK pharmaceutical industry is one of the country’s largest. 45 million packets of medicine leave the UK for the EU-27 each month, while 37 million packets are imported. €3 billion of medical devices are imported to the UK from the EU-27, compared to exports of €2 billion.
Pharma bosses have warned that they face multi-million euro contingency costs, while some clinical trials on new medicines will be put on hold until they have greater certainty on what the UK’s relationship with the EU is likely to look like.
The ‘contingency-effect’ has also affected the European Medicines Agency – which licenses and regulates products across the bloc. As a result of its relocation from London to Amsterdam in 2019, the EMA has downgraded its work on pediatric medicines and anti-microbial resistance.
Health Minister Jeremy Hunt and Business Minister Greg Clark have called for a ‘deep and special relationship’ with the agency but it remains unclear how many of its functions will have to be taken on by the Medicines and Healthcare Products Regulatory Agency (MHRA), the UK’s domestic regulator.
“We must have a transition until at least December 2020,” said Lloyd Davies.
The agreement on Phase One of the Brexit talks struck in December protects patients who have already started a treatment when the UK leaves the EU in March 2019.
Understanding of the potential impact of Brexit on public health across Europe remains low, delegates warned.
“To be perfectly honest it’s not on the radar of national organisations,” said Nicola Bedlington, Secretary General of the European Patients Forum.
“In the EU-27 there is a lack of awareness.”
However, she pointed out that “in the UK the patient community is hugely engaged.”
The message from the health community is not entirely pessimistic, however.
“I don’t think our messages have fallen entirely on deaf ears,” says Matt Dixon, Chief Executive of the NHS Confederation.
“Some of the most hard-Brexit oriented ministers have started to change their stance as they see the complexity.”
A ‘hard Brexit’ would pose the greatest disruption for the European healthcare sector and patients, particularly if there is no mutual recognition agreement on clinical trials, batch testing and diagnostics.
But patients could face a long delay for new drugs even if the UK swiftly agrees on a free trade deal with the EU, according to a report published on 29 January by the Brexit Health Alliance.
Switzerland starts receiving new drugs an estimated 157 days after the EU, despite having a series of bilateral trade agreements with the EU. That is because drug companies tend to target their new products at the largest markets. The UK accounts for around 3% of global drug sales compared to the EU’s 25%.
UK ministers have also been urged to be ready to prepare emergency laws to protect against disruption to the supply of medicines.
Emergency trauma kits, which are commonly used by health workers responding to terrorist attacks, can currently be flown in at a moment’s notice. A recent report by a UK parliamentary committee warned that customs checks could add a minimum of five hours to the transportation time.