Key Summary
- For cancer medicines, England ranks 14th, and Scotland ranks 19th.
- For orphan medicines, England ranks 11th, and Scotland 13th.
- ABPI lauds the recent UK-US pharmaceutical arrangement and the recent changes to the NICE baseline threshold.
England ranks seventh out of 36 European countries in providing its patients access to the medicines approved by the European Medicines Agency (EMA) between 2021 and 2024.
This was revealed in the annual Patients Waiting to Access Innovative Therapies (W.A.I.T.) report, published by the European Federation of Pharmaceutical Industries and Associations (EFPIA).
The report tracks the availability and speed of access for patients in national health systems, and is one of the most comprehensive datasets on the availability of publicly funded new medicines across Europe.
From 2021 to 2024, around 61 percent of EMA-approved medicines have been approved by the UK’s Medicines and Healthcare products Regulatory Agency (MHRA) and are recommended by the National Institute for Health and Care Excellence (NICE) for NHS use in England. Scotland ranks 11th (53 percent).
Among those countries similar to the UK in terms of population and economy (France, Germany, Italy, Spain), England ranks fourth, behind Germany, Italy and Spain.
However, when considering the medicines for restricted patient groups – known as an “optimised” NICE recommendation, England slips to 10th position.
Only 33 percent of medicines licenced during these four years were available on a full, unrestricted basis in line with their regulatory licence. Scotland drops to 13th position.
Cancer, rare disease drugs are scarce
Cancer and rare disease patients face the biggest gaps in medicine availability.
For cancer medicines, England ranks 14th, with 59 percent new medicines available to NHS patients.
Scotland ranks 19th (48 percent).
Many of these patients are waiting for treatments that could extend or save their lives.
For orphan medicines – developed for rare diseases with few treatment options – England ranks 11th (50 percent) and Scotland 13th (47 percent).
For these patients, access to a single medicine can often mean the difference between having a treatment option and having none.
More needs to be done: ABPI
The Association of the British Pharmaceutical Industry (ABPI) has said that the UK needs to better reflect the value of medicines for patients with few or no alternatives.
The government has taken some recent measures to speed up medicine approvals for use on the NHS.
From MHRA approval to access decision, England has risen to 5th (332 days) and Scotland to 6th (347 days), but timelines still lag pre-2024 levels.
The ABPI’s analysis of EFPIA’s new Regulatory Indicator shows that around one-third of US-licensed medicines are not licensed in Europe or the UK.
This reinforces the concern that UK patients are missing out on medicines available elsewhere.
The UK-US pharmaceutical arrangement and the recent changes to the NICE baseline threshold is an important first step to bring more medicines to NHS patients, it added.
ABPI also pointed out that work to better align NICE and MHRA processes would reduce unnecessary delays between a medicine being approved as safe and effective and its availability on the NHS.
These changes reflect a genuine government understanding that the UK’s position as a destination for innovative medicines and its attractiveness to R&D investors depend on patients' ability to access them.
The 2026 EFPIA W.A.I.T. and Regulatory Indicator report is a reminder that, while progress is being made, a significant gap remains between where the UK is and where it needs to be, it added.
