The UK government has announced an agreement with the US for zero tariffs on the supply of branded medicines from the UK to the US for at least three years.In return, the UK will increase spending by 25% on innovative, safe and effective treatments.1 The National Institute for Health and Care Excellence (NICE) will increase the threshold for a quality-adjusted life year (QALY) from £20,000-£30,000 to £25,000-£35,000 from April 2026.[2] The NICE threshold for a QALY will increase from £20,000-£30,000 to £25,000-£35,000 by April 2026.[1] The rebate that pharmaceutical companies return to the NHS under the VPAG scheme on higher sales will be capped at 15%.The rebate reached 22.9% in 2025 and will fall to 14.5% in 2026 as growth slows.The deal is intended to ensure zero tariffs on medicines exported to the US and to encourage investment by UK firms.1[1][5] The rebate will be capped at 15% in 2025.