Highlights from the UK’s December 2025 VPAG metrics
Leela Barham looked at the latest metrics, only just available in March 2026 and covering up to October 2025, used to monitor the UK’s voluntary pricing scheme.
Metrics
The UK’s Voluntary Scheme for Branded Medicines Pricing and Access (VPAG) include metrics that are used to monitor the scheme by the Department of Health and Social Care (DHSC) and the research-based industry association, the ABPI. Medicines UK, the Ethical Medicines Industry Group (EMIG), and the BioIndustry Association (BIA) are observers to operational reviews, so, presumably they also get to see the metrics even if they can’t comment on them within the meetings (must be frustrating!).
The current scheme has been running since 1st January 2024. Despite a commitment to reviewing metrics every six months, the third set was only made available on 4th March 2026. That’s been driven by an earlier-than-planned review of the scheme, prompted by high payment rates and changes to the scheme as part of the UK/USA pharmaceutical trade deal announced on 1st December 2025.
The latest metrics were reviewed in December 2025, according to minutes from the operational review meeting published on 20th February 2026. These add to the metrics packs dated July 2024 and December 2024.
On the up
There was some good news in the metrics reviewed in December 2025.
The ABPI, in the 3rd March blog by Pinchas Kahtan, highlighted “early signs of a modest recovery in clinical trial recruitment” in the December 2025 VPAG metrics. The DHSC also noted this, but suggested that there was “incomplete recovery” in clinical trial recruitment in the operational review meeting minutes.
It was the DHSC who noted in the operational review meeting minutes that there has been “very strong growth in new active substance (NAS) sales,” presumably good news for the companies selling them.
Another positive pointed to by the DHSC included the continued growth in PharmaScan records; by December 2025, there were “nearly 10% more records on PharmaScan than there were in April 2024”, according to the metrics pack. PharmaScan helps the NHS to be prepared for new treatments coming their way, and companies sharing information is all part of that effort.
Going down
There was some not-so-good news in the metrics, too.
The DHSC pointed to “rising mean and median durations of NICE technology appraisals (TAs) since the year 2024 to 2025” in their discussions of the metrics during the operational review meeting.
The total mean days for publication of NICE TAs in 2025/26 (but incomplete, running from 1st April 2025 to 31st October 2025) was 349, just above the target of 335 days, whereas it was an average of 335 in 2024/25.
What’s driving this are “divergent” appraisals that took 386 days on average in 2025/26, but that’s still an improvement of 409 days in 2024/25. Divergent appraisals are those that aren’t optimal. A host of criteria determine when an appraisal is optimal, ranging from NICE receiving a notification about the product more than 16 months before the GB marketing authorisation (for more details, see my earlier article, Is money the only metric that really matters in the UK’s VPAG? It shouldn’t be).
That it’s taking NICE longer goes against the aim to speed things up at the institute, but, credit where credit is due, much progress has been made over the longer term.
A higher-than-usual rate of terminations of NICE appraisals by companies was noted by the DHSC. The metrics pack gives the numbers: 14 terminations for 2025/26 so far (14% of NICE recommendations made), close to the 16 seen for the full 2024/25 financial year. According to NICE, however, “termination peaks are historically normal” and, further, that they were “not cause for immediate policy action,” as recorded in the operational review meeting minutes.
The DHSC also described “a sharp reduction in overall new-medicine year-to-date sales growth.”
Kahtan noted slowing growth in the use of newer branded medicines and the changes in appraisal timelines in his blog.
Lagging behind
As the operational review meeting minutes note, the metrics are behind the times. The impact of changes, not least the Most-Favoured Nation (MFN) policy, as well as the impact of changes agreed as part of the UK/USA pharmaceutical trade deal, won’t yet affect the metrics. Changes coming in from that deal include boosting the NICE cost-effectiveness threshold, as well as a commitment that the UK will spend more on medicines.
New metrics
The December 2025 metrics pack has some new metrics. They include UK research and development expenditure on pharmaceuticals from the ONS (trending up, but a break in the series makes this difficult to work out how much is from the new methodology being used), UK inward foreign direct investment in life sciences (trending down), equity finance raised by the UK life sciences industry (trending down), as well as recruitment to interventional clinical trials on the National Institute for Health Research (NIHR) Research Delivery Network (RDN) portfolio (with some pick up from an overall fall over time). Plus, there are updates on the Sustainable Medicines Manufacturing Innovation Programme. The programme aims to drive innovation, adoption, investment, and collaboration in the UK’s medicines manufacturing sector and is funded by VPAG as part of the VPAG Investment Programme.
There’s still little to really place the UK in the international context, though. The OLS Life Science Competitiveness Indicators help with that, even if they aren’t formally referenced. The 2025 indicators came out on 23rd March 2026.
The 2025 indicators cover 2023 and 2024, so it’s lagged and the UK generally isn’t a leader, aside from median number of days from clinical trial application to regulatory authority and first patient receiving a first dose for a subset of interventional commercial trials for novel medicines across all trial phases. Presumably, future iterations will be better placed to shed light on the impact of changes made to the VPAG as a result of a trade deal struck with the US.
ABPI MIIS
The ABPI has its own intelligence to help the industry monitor VPAG. That includes the Medicines Impacts and Investment Survey (MIIS). The operational review meeting minutes highlight a discussion on the survey results that ran from September to October 2025, based on 42 company responses.
The meeting minutes don’t note that this is a low response rate; according to DHSC, 257 companies were members of VPAG on 1st December 2025 (the nearest data to when the survey was run). Not only that, but the survey “reached all VPAG and statutory scheme members”, which means that the response rate is even lower. There is no definitive list of statutory scheme members.
The findings are more sobering than the VPAG metrics because the ABPI suggested that they showed a “continued decline in the UK’s global launch priority.” Too soon to tell if sentiment has shifted because of the UK/USA pharmaceutical trade deal and the changes to VPAG.
The ABPI suggested that around 20% of expected launches were “adversely affected.” That the results come from the companies that have an interest – and perhaps even more than those that didn’t see the value in responding to the survey at all – was clear in the comment that the DHSC “cautioned about self-selection bias.”
For those who want to know more about MIIS, the ABPI shared more details in January 2026. A re-run of the survey is also planned for late 2026.
Future metrics?
Kahtan suggested that there might be yet more changes in the metrics. He wrote, “There is agreement that the next step is to place more focus on real-world outcomes, including how many medicines reach patients in routine NHS care.” That’s ambitious, but it is something that really matters.
