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A trade agreement with the US after a no-deal Brexit could be fatal for the NHS, campaigners warn.

The health service could be forced to pay hugely inflated prices for medication.

Powerful American corporations are eyeing up the NHS and want to put an end to the health service keeping its costs down.

Leaving the EU without a deal would make the UK heavily reliant on a trade agreement with the US.

Campaigners say this desperation would put us in such a weak position we would have to make major concessions.

And the NHS, which spends £140billion annually, is the prize the US companies want.

Health campaigner Diarmaid McDonald said: “The demands of the US could take a wrecking ball to the NHS budget, pushing it to the edge of bankruptcy and putting the lives of patients across the UK at risk.”

How drug and operation prices differ across the Atlantic

(Image: PA)

The Office of the US Trade Representative has published a summary of objectives for US-UK trade negotiations after Brexit .

US pharmaceutical firms, known as Big Pharma, want “full market access for US products” and say mechanisms keeping NHS drug prices low are “unreasonable”.

Without these price controls the cash-strapped NHS could be paying hugely inflated American costs – up to six times more for operations and over 20 times more for some medication.

Acid reflux drug Nexium costs 66p per pill in the UK – and £7.40 in the US.

(Image: Getty)

A hip replacement there is as much as £37,000. The same surgery costs the NHS around £7,500.

Fearing bad publicity, Boris Johnson this week told ministers they must not discuss the NHS in any trade deal with the US.

But critics say his words should be taken with a pinch of salt.

His previous promises include “lying down in front of bulldozers” to stop a third runway at Heathrow, but when the issue got to the Commons he went on a diplomatic visit abroad to avoid voting against the Government.

On his state visit in June, Donald Trump said the NHS was “on the table” in US-UK negotiations, but he later rowed back on the comment after public uproar.

(Image: Getty)

His US Ambassador to the UK, billionaire Woody Johnson also said the NHS would be fair game in trade negotiations.

Dr Tony O’Sullivan, co-chair of campaign group Keep Our NHS Public, said: “The verbal assurances from Johnson that the NHS won’t be in trade deals are nothing more than hot air.

“We’ve had false assurances that the Government isn’t privatising the NHS when it is already.

“A trade deal with the US would be the death knell of the NHS and would nail down the market in the NHS for ever.

“We demand total assurance the legislation will be changed and we will re-nationalise the NHS.”

More than 700,000 people have so far signed a petition demanding the Government guarantees the NHS will never form part of a trade deal with the US.

(Image: Getty)

Big Pharma, worth £1.3trillion annually to the US economy, is said to be the most profitable industry in the world. It has one of the most powerful lobby machines in Washington, with Trump and his top staff rubbing shoulders with the big bosses.

Over 90% of Americans have health insurance – leaving around 28 million who are uninsured.

The average premium paid by Americans is £360 a month.

Mr McDonald, founder of pressure group Just Treatment, said: “There are people in the US who are dying because they can’t afford their medicines and their health system can’t provide them access.

“Young people are dying when they drop off their parents’ insurance as they can’t afford insulin.

“That’s one example of the kind of crisis we risk facing in the UK if we are left with the same kinds of unregulated drug prices they have in the US.

“The US wants to strip back controls that keep our drug prices ‘reasonable’... They want NHS drug costs to rocket.

(Image: PA)

“We risk a situation where the drug companies have more ability to demand high prices and our NHS has got less power to resist...

“We’ll be forced to pay prices which suck money from the NHS to put it into the pockets of multi-billion dollar US companies.”

The buying power of the NHS, which deals with over a million patients every 36 hours, means it can negotiate cheaper deals.

The indicative NHS cost per pill of Daraprim is £2.30, compared to £619 in the US. Last year US drug giant Vertex refused a £500million offer from the NHS for access to cystic fibrosis drug Orkambi, which could save children with the disease.

Mr McDonald said: “The price in the US for Orkambi is around £210,000 per patient per year.

“It’s insane. That’s what happens when you don’t have the price controls the NHS has.

“In the UK the price is £104,000, so we’d pay less than the US, but it’s still an extortionate amount of money and more than the NHS can afford.”

(Image: AFP/Getty Images)

Just Treatment is campaigning for an affordable generic Orkambi on the NHS. The relatively low prices the NHS pays for branded medicines infuriates Big Pharma.

What is even worse for them is that what the NHS pays is a reference price for up to 25% of global pharmaceutical sales.

The Association of the British Pharmaceutical Industry said: “Pharmaceutical companies have voluntarily signed up to a five-year agreement which controls how much the NHS can spend on medicines; this will not change.

“The strict processes the UK has in place to ensure value for money mean we have some of the lowest prices for medicines in Europe and this is good for NHS patients.”

American trade group PhRMA declined to comment.