The NHS is to pay 25% more for innovative drugs in return for zero tariffs on exports of pharmaceuticals to the US under a deal with Donald Trump’s government.

Industry sources estimate it could cost about £3bn in higher spending on drugs over the next three years but also increase the portion of the NHS budget spent on medicines for diseases such as breast cancer, asthma and motor neurone disease, where innovation is key.

The National Institute for Health and Care Excellence (Nice), which sets the guidelines for expenditure on new drugs, currently approves about 70 new medicines a year. It is estimatedthe increased spending thresholds will add about three to five new drugs a year.

The office of the US trade representative, Jamieson Greer, said the deal would “reverse the decade-long

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