Donald Trump is ready to use trade talks to force the National Health Service to pay more for its drugs as part of his scheme to "put American patients first”.

Mr Trump has claimed that the high costs faced by US patients are a direct result of other countries’ health services “freeloading” at America’s expense.

Alex Azar, the US Health and Human Services Secretary, has said Washington will use its muscle to push up drug prices abroad, to lower the cost paid by patients in the United States.

"On the foreign side, we need to, through our trade negotiations and agreements, pressure them," Azar said on CNBC.

"And so we pay less, they pay more. It shouldn't be a one-way ratchet. We all have some skin in this game."

He continued: "The reason why they are getting better net prices than we get is their socialised system."

In the UK, prices are dictated in part by National Institute for Health and Care Excellence (NICE) which has been successful in securing discounts for some of the costliest drugs.

Single-payer government-run health services like the NHS are able to use their negotiating muscle to pay far lower prices than their fragmented insurance-based private American counterparts, to the fury of the US president.