Question to the Department of Health and Social Care:

To ask His Majesty's Government, further to the Written Answer by Baroness Merron on 5 January (HL13176), what safeguards they plan to put in place to ensure that integrated care boards are subject to proper scrutiny, particularly in relation to the incorporation of patient engagement work into the commissioning of services.

Answered by Baroness Merron - Parliamentary Under-Secretary (Department of Health and Social Care)

Integrated care boards currently have a statutory duty in relation to public involvement and consultation and are subject to an annual assessment by NHS England of their functions.

The abolition of Healthwatch England and Local HealthWatch arrangements will require primary legislation and is subject to the will of Parliament.

Question to the Department of Health and Social Care:

To ask His Majesty's Government what assessment they have made of adjusting the National Institute for Health and Care Excellence cost-effectiveness thresholds for highly specialised technology in line with the new single technology appraisal cost-effectiveness thresholds due to come into effect from April.

Answered by Baroness Merron - Parliamentary Under-Secretary (Department of Health and Social Care)

We have reached a landmark agreement with the United States of America that secures a preferential tariff rate of 0% for all pharmaceuticals exports to the US for at least three years, and preferential terms for the United Kingdom’s medical technology exports, meaning no additional new tariffs on medical technology. This means that, unlike anywhere else in the world, life sciences companies exporting medicines from the UK to the US will face no tariffs to do so, protecting jobs and investment in the UK.

The agreement will see the National Health Service invest approximately 25% more in innovative treatments which will be achieved through an increase to the standard cost-effectiveness threshold that the National Institute for Health and Care Excellence (NICE) uses and a change to the way in which NICE values health benefits to better reflect societal preferences.

There are currently no plans to increase the cost‑effectiveness threshold for the highly specialised technologies (HST) programme. The HST programme already operates at a much higher threshold than standard NICE technology appraisals, reflecting the challenges of bringing treatments for very rare conditions to market, and NICE has been able to recommend nearly all the treatments that have been evaluated through the HST programme for NHS use.

Question to the Department of Health and Social Care:

To ask His Majesty's Government what assessment they have made of the impact of increasing the National Institute for Health and Care Excellence highly specialised technology cost-effectiveness threshold on patient access to rare disease medicines.

Answered by Baroness Merron - Parliamentary Under-Secretary (Department of Health and Social Care)

We have reached a landmark agreement with the United States of America that secures a preferential tariff rate of 0% for all pharmaceuticals exports to the US for at least three years, and preferential terms for the United Kingdom’s medical technology exports, meaning no additional new tariffs on medical technology. This means that, unlike anywhere else in the world, life sciences companies exporting medicines from the UK to the US will face no tariffs to do so, protecting jobs and investment in the UK.

The agreement will see the National Health Service invest approximately 25% more in innovative treatments which will be achieved through an increase to the standard cost-effectiveness threshold that the National Institute for Health and Care Excellence (NICE) uses and a change to the way in which NICE values health benefits to better reflect societal preferences.

There are currently no plans to increase the cost‑effectiveness threshold for the highly specialised technologies (HST) programme. The HST programme already operates at a much higher threshold than standard NICE technology appraisals, reflecting the challenges of bringing treatments for very rare conditions to market, and NICE has been able to recommend nearly all the treatments that have been evaluated through the HST programme for NHS use.

Question to the Department of Health and Social Care:

To ask His Majesty's Government what their rationale is for increasing the National Institute for Health and Care Excellence (NICE) cost-effectiveness thresholds for assessing new medicines to £25–30,000 per quality-adjusted life year; and whether they plan to apply the same proportionate increases to the NICE cost-effectiveness thresholds for highly specialised technologies.

Answered by Baroness Merron - Parliamentary Under-Secretary (Department of Health and Social Care)

We have reached a landmark agreement with the United States of America that secures a preferential tariff rate of 0% for all pharmaceuticals exports to the US for at least three years, and preferential terms for the United Kingdom’s medical technology exports, meaning no additional new tariffs on medical technology. This means that, unlike anywhere else in the world, life sciences companies exporting medicines from the UK to the US will face no tariffs to do so, protecting jobs and investment in the UK.

The agreement will see the National Health Service invest approximately 25% more in innovative treatments which will be achieved through an increase to the standard cost-effectiveness threshold that the National Institute for Health and Care Excellence (NICE) uses and a change to the way in which NICE values health benefits to better reflect societal preferences.

There are currently no plans to increase the cost‑effectiveness threshold for the highly specialised technologies (HST) programme. The HST programme already operates at a much higher threshold than standard NICE technology appraisals, reflecting the challenges of bringing treatments for very rare conditions to market, and NICE has been able to recommend nearly all the treatments that have been evaluated through the HST programme for NHS use.

Question to the Department of Health and Social Care:

To ask His Majesty's Government what plans they have to develop a long-term strategy alongside medical professionals to ensure sustainable funding for obesity services, including prevention, behavioural and psychological programmes, and alongside clinical treatments.

Answered by Baroness Merron - Parliamentary Under-Secretary (Department of Health and Social Care)

The National Health Service and local government provide a range of obesity services, from universal prevention initiatives to targeted interventions, including behaviour change programmes, digital tools and apps, and specialist services for people living with severe obesity and related conditions. These services support individuals at every stage to achieve and maintain a healthier weight.

Commissioning and funding decisions for obesity services are made locally by local authorities and NHS organisations in line with assessed population needs and available budgets. The Department works with these partners and NHS England to provide national policy direction, to support effective and sustainable service models and to introduce digital behavioural programmes.

NHS England is supporting integrated care boards (ICBs) to deliver a phased roll‑out of tirzepatide for the treatment of obesity. They have provided funding and guidance to ICBs and established a national wraparound support service for patients receiving these treatments, covering diet, physical activity, and behaviour change.

As set out in our 10-Year Health Plan for England, we are taking decisive action on the obesity crisis, including restricting junk food advertising to children, and setting healthy sales reporting and targets for large food businesses.

Whilst we recognise that prevention will always be better than a cure, we also need to support those already living with obesity. We have committed to doubling the number of people able to access the NHS Digital Weight Management Programme and to expand access to the newest obesity medicines.

Question to the Department of Health and Social Care:

To ask His Majesty's Government, in the light of reports about the pricing structure of weight-loss medications used in the NHS, (1) what discussions they have had with Novo Nordisk and Eli Lilly, and (2) what steps they are taking to ensure that costs do not exacerbate regional inequalities in access to treatment.

Answered by Baroness Merron - Parliamentary Under-Secretary (Department of Health and Social Care)

Commercial access agreements, including confidential discounts, are negotiated to secure affordability and value for money for the National Health Service, and to enable access to clinically effective treatments that may not otherwise meet cost effectiveness thresholds at list price. As is standard across NHS medicines commissioning, the specific terms of commercial agreements remain confidential to protect the NHS’s negotiating position and to ensure best value for public funds.

NHS England, alongside the Department and the National Institute for Health and Care Excellence, routinely engages with pharmaceutical companies, including Novo Nordisk and Eli Lilly, through standard market access and appraisal processes, and commercial and supply discussions following NICE recommendations, and ongoing dialogue on implementation, demand management, and system readiness. NHS England does not comment publicly on the detail of individual commercial negotiations.

For weight management medicines, NHS England is supporting implementation via a phased and prioritised rollout approach. Prioritising populations with the greatest clinical need aligns with NHS objectives to reduce health inequalities.

NHS England is working with regions and integrated care boards to support consistent implementation of national policy, and to address unwarranted variation through guidance, oversight, and data monitoring. These approaches are designed to ensure that cost pressures do not drive postcode-based inequities, while enabling the safe and sustainable introduction of new treatments at scale.

Question to the Department of Health and Social Care:

To ask His Majesty's Government what steps they plan to take to increase transparency around commercial pricing agreements for new weight-loss medications within the NHS, including how pricing decisions reflect anticipated long-term clinical and economic outcomes.

Answered by Baroness Merron - Parliamentary Under-Secretary (Department of Health and Social Care)

Commercial access agreements, including confidential discounts, are negotiated to secure affordability and value for money for the National Health Service, and to enable access to clinically effective treatments that may not otherwise meet cost effectiveness thresholds at list price. As is standard across NHS medicines commissioning, the specific terms of commercial agreements remain confidential to protect the NHS’s negotiating position and to ensure best value for public funds.

NHS England, alongside the Department and the National Institute for Health and Care Excellence, routinely engages with pharmaceutical companies, including Novo Nordisk and Eli Lilly, through standard market access and appraisal processes, and commercial and supply discussions following NICE recommendations, and ongoing dialogue on implementation, demand management, and system readiness. NHS England does not comment publicly on the detail of individual commercial negotiations.

For weight management medicines, NHS England is supporting implementation via a phased and prioritised rollout approach. Prioritising populations with the greatest clinical need aligns with NHS objectives to reduce health inequalities.

NHS England is working with regions and integrated care boards to support consistent implementation of national policy, and to address unwarranted variation through guidance, oversight, and data monitoring. These approaches are designed to ensure that cost pressures do not drive postcode-based inequities, while enabling the safe and sustainable introduction of new treatments at scale.