A. No Deal, i.e. a failure to reach a Free Trade Agreement with the EU – likely results:

  1. Imported medicines from the EU likely to be delayed, perhaps by months, because of bottlenecks at Dover and Folkestone – this would require massive stockpiling and good supply management within the UK to ensure that there are no shortages. Unfortunately, as the 2019 stockpile has gone and global demand will remain high, the probability of the UK being able to stockpile is very low and the chance of shortages high.
  2. UK highly likely to be excluded from the European Rare Diseases Network, which could mean that “orphan medicines”* might not reach the UK market – a bad outcome for those suffering from rare diseases. By the end of the transition period, an ‘orphan designation holder’ currently in the UK must relocate to an EU Member State.
  3. Emergency services crisis: a No Deal coming on top of COVID-19 would overwhelm local authority emergency response teams, including NHS emergency teams.
  4. UK has left the European Medicines Authority. This means (a) lost opportunities for UK researchers and suppliers (b) after 31 December 2020 no access for the UK to the EU’s rapid authorisation for pandemic vaccines and medicines for treatment.
    Setting up a UK medicines authorisation regime separate from the EU could lead to further delays in drug authorisation and supply. UK pharmaceutical commercial sales/supplies and clinical trial supplies TO the EU will have significantly increased timelines and costs. This is bound to impact the UK pharmaceutical industry.
  5. EU emergency bulk buying mechanism for vaccines and medicines: the UK is highly likely to withdraw from this, and could then have to pay more to access them.
  6. Partnerships with key EU health bodies such as the European Centre for Disease Prevention and Control are likely to end – a very short-sighted move. The British Government’s handling of the current COVID-19 pandemic in Britain has been woeful, and this ‘exceptionalist’ approach will make similar outcomes likely in the event of future pandemics.
  7. The ending of reciprocal healthcare agreements (highly likely) could leave UK nationals in the rest of the EU without health care and will force UK nationals visiting EU countries to pay for emergency health treatment via travel health insurance.
  8. Recruiting NHS medical staff from EU countries (over 22,500 have left the NHS since the Referendum) will become even harder, and there could be changes to current rules regarding the mutual recognition of medical qualifications.

B: A minimal deal with the EU: likely results:

4.-8. above would still apply.

*“Orphan medicines” are pharmaceutical agents which would not be profitable to produce without government assistance, either because of the rarity of the disease to be treated or because revenue from the medicinal product is low although the disease is common, eg parasitic infections in poor countries.