The UK life sciences sector at a crossroads: Bold decisions to remain a global leader

This article was developed and funded by Gilead Sciences Ltd.

For decades, the UK life sciences sector has been the jewel in the crown of British industry. Its combination of a world-leading science base, the scale of the NHS, and a globally competitive pharmaceutical ecosystem provide a unique and attractive offering as a location to foster and deliver medical innovation.

It’s also critically important to UK growth and prosperity. The sector contributes over £17 billion annually to the economy, supports more than 120,000 high-skilled jobs, and accounts for around 17% of all business R&D spending.¹ In short, it is something to be immensely proud of, to nurture, and to protect.

Yet, it is increasingly evident that growing challenges pose a clear threat to the long-term health of this sector. While some are linked to recent global instability, many are the result of decisions made by governments and health service decision-makers over time. The result is not simply declining investment, it is reducing confidence in the UK as a base for life sciences innovation.

Investment in growth and scientific innovation must be a key part of the strategy to reverse this trend. As part of the recent US-UK pharmaceuticals agreement, the government committed to doubling spending on innovative medicines as a proportion of GDP from 0.3% to 0.6% by 2036,² with the aim to deliver wider and faster access to treatments for patients. However, 10 years is a long time. If we are to make this increase meaningful, we need to be thinking about how we accelerate this investment. Bold decisions will have to be made – in partnership with life sciences companies – to translate ambition into reality and to keep the UK at the forefront of this sector.

Warning signs to be heeded

The UK has historically been an early access market, with new treatments typically introduced ahead of many other countries. However, a range of factors have eroded the value of prioritising the UK over other European and global markets. The UK has underinvested in medicines for decades, and remains lower compared with many G7 peers.³ Cost-effectiveness thresholds – while adjusted recently in England⁴ – have not kept pace with even basic markers such as inflation. This ultimately impacts access.

As the UK’s attractiveness as an early launch market declines, so too does the appetite to invest. Foreign direct investment (FDI) in life sciences fell by 58% between 2017 and 2023, pushing the UK from second to seventh in global rankings.³ The UK’s share of global commercial clinical trial patients has dropped from 4.2% in 2015 to 2.6% in 2022 – a 38% reduction in just seven years.⁵ These figures point to more than a debate over medicine pricing; they signal an ecosystem under growing strain.

The need to prioritise innovation

Encouragingly, there have been several policy announcements that strive to address these challenges. The 2025 Life Sciences Sector Plan committed to strengthening the UK’s global competitiveness, accelerating clinical research, and improving patient access to innovation.⁶ The NHS England 10-Year Plan set out ambitions for prevention, faster uptake of innovation, and improved system productivity.⁷

The challenge now lies in translating ambition into action. If the desire is to harness the UK’s deep heritage and to truly lead global progress in this field, nurturing innovation – from inception to access – has to be front and centre. A simple reality is that this requires investment.

Positioning health innovation as a growth driver, not a cost burden

Too often, discussion is quick to pivot from a call for investment into concern over overall spend. But it is vital to place debates around medicine spend and reimbursement in a wider context. Currently, medical innovation is too often seen as a cost burden – an overspend to be restricted and contained. This is simply not accurate.

Successful implementation of new medical technologies is unquestionably a growth driver. It is better for the economy, can improve work and societal pressures and, most crucially, can change the lives of people impacted by serious diseases.⁸ Yet, the UK spends less than many of its economic peers on medicines and lacks the commercial flexibility needed to keep pace with the speed of scientific progress.

Over the past decade, the real value of the UK branded medicines market has declined by 11%, even as the NHS budget grew by a third.⁹ In many cases, the commercial terms required for NHS access can significantly constrain returns on innovation. For a commercial sector, this is simply not sustainable. We must reframe the narrative and recognise innovation for the opportunity it is.

The government’s commitment to increase spend on innovative medicines to 0.6% of GDP, which include therapy areas like HIV and cell therapy, demonstrates intent to maintain a competitive position.² However, as with many policy announcements, the proof will be in the execution and timeline. The sector needs tangible investment and action to achieve short-term progress while balancing long-term ambitions. There needs to be greater flexibility and collaboration to support the adoption of innovative technologies, meaningful spend increases in the next two to three years, as well as fresh thinking around pilots, cost-effectiveness assessments, and prescribing pathways, so that these medicines can reach those who need them as quickly as possible.

Real-world issues hampering growth

While long term growth and sustainable success is the ultimate goal, it demands addressing some of the real-world challenges being faced today. The ABPI’s 2025 MIIS survey found that two-thirds of companies had delayed or deprioritised at least one UK launch, even where those medicines were already available to patients across the EU. Nine in ten companies cited high and volatile rebate rates, alongside cost-effectiveness thresholds, as key drivers of this trend.¹⁰

The gap between UK and other comparable markets on access to new medicines is stark. Around 37% of new medicines are made fully available for their licensed indications in the UK, compared to 90% in Germany.³ The NICE cost-effectiveness thresholds for England were updated in 2026⁴ – a step in the right direction that will bring a few important medicines into scope for NHS recommendation. However, high innovation medicines that may carry uncertainty or more complex datasets remain at risk.

Groundbreaking technologies in oncology, rare disease, and disease prevention will continue to struggle against conventional methodologies. A more holistic framework is needed: one that better balances the need for rigorous assessment with the importance of reducing delays. Other markets are making progress - Germany, France, and other markets have evolved their processes. The UK needs to keep pace.

The other key challenge is enabling companies to price innovation in a way that accurately reflects value. Greater commercial flexibility and a partnership-based approach are essential. Currently, the ability to have bespoke discussions and put forward creative reimbursement solutions can be inconsistent and opaque. When it works, patients, the NHS, and the industry benefit by creating new care pathways, helping patients live longer and fuller lives, and easing pressures on services. But for every agreement reached, there are many where the door simply shuts. More transparency, earlier dialogue, more flexibility, and more creativity are the solutions. This doesn’t mean excessive or uncontrollable spending, but it could mean significant narrowing of the gap between approval and access.

It also means finding a long-term solution to rebates on branded medicines, which have created uncertainty for several years. Recent updates to the VPAG framework demonstrate progress, but 2028 will come around quickly and we need to start planning beyond it now.

Partners, not adversaries

I have worked in the UK for some time and am continually inspired by the people working in and around the life sciences sector. Pharma and biotech innovation in this country has unlimited potential. But we are fighting a fierce current and a narrative that too often comes across as adversarial. This needs to change.

We all want the same thing: for the UK to succeed, for our workforces to thrive, and for patients and the NHS to benefit. If we work together and think creatively, the possibilities are almost endless.

UKI-COR-0162 | June 2026

About the author

Peter Wickersham is the Vice President and General Manager of Gilead Sciences Ltd UK & Ireland, a leader in the treatment of HIV, liver disease, lymphoma, and breast cancer. Wickersham is deeply committed to serving patients and supporting access to innovative medicines that can truly change lives. With over 25 years in healthcare, working in both pharmaceuticals and pharmacy management, he is an accomplished commercial leader with extensive business experience and a comprehensive understanding of the entire pharmaceutical landscape – from early-stage clinical development to the commercial launch of transformative therapies and product lifecycle management. Wickersham combines his deep experience in industry and health delivery to drive patient-led therapy and health system innovation.

About Gilead Sciences

Gilead Sciences, Inc. is a biopharmaceutical company that has pursued and achieved breakthroughs in medicine for more than three decades, with the goal of creating a healthier world for all people. The company is committed to advancing innovative medicines to prevent and treat life-threatening diseases, including HIV, viral hepatitis, COVID-19, and cancer. Gilead operates in more than 35 countries worldwide, with headquarters in Foster City, California.