Unveiling the ABPI MIIS Report: A Snapshot of 2025's Turbulence in UK Life Sciences

The Association of the British Pharmaceutical Industry (ABPI) has released its highly anticipated Medicines Impacts and Investment Survey (MIIS) report for 2025, titled "A Year of Uncertainty: UK Life Sciences Investment and Medicine Launches in 2025." This comprehensive survey, drawing insights from 42 major life sciences companies, provides a stark assessment of the sector's challenges amid policy volatility and global competition. The report highlights how escalating pressures have led to paused investments totaling around £2 billion, delayed medicine launches, and anticipated workforce reductions, underscoring the urgent need for stable policy frameworks to safeguard patient access and economic growth.

Life sciences in the UK, encompassing pharmaceuticals, biotech, and medtech, form a cornerstone of the economy, supporting 125,000 high-skilled jobs and contributing £17 billion in gross value added (GVA) annually through £9.3 billion in research and development (R&D) spending. Yet, 2025 marked a pivotal year of uncertainty, driven by rapid changes in pricing mechanisms and regulatory hurdles that have eroded investor confidence.

Sharp Decline in Investments: £2 Billion Paused and FDI Trends

One of the report's most alarming findings is that 79% of surveyed firms considered operational or investment reductions in the UK since January 2024, with 91% doing so when weighted by full-time equivalent (FTE) employees. Approximately three-fifths of these companies proceeded with cuts, deferrals, or cancellations, primarily targeting clinical trials and R&D programs—cited by two-thirds of respondents. Overall, around £2 billion in investments were paused or cancelled in 2025 alone.

Foreign direct investment (FDI) in life sciences has plummeted, dropping 58% from £1,897 million in 2021 to £795 million in 2023, causing the UK's global ranking to slip from 2nd to 7th among peers. UK pharmaceutical R&D investment has grown at a sluggish 1.9% annually since 2020, compared to the global average of 6.6%, and even declined by nearly £100 million in 2023. Biotech venture capital (VC) funding reflected this caution, with the BioIndustry Association (BIA) reporting £1.79 billion raised in 2025 across 58 deals—a 13% decline from 2024—despite a resilient Q4 with 22 deals and larger average sizes (£30.8 million).

Examples include MSD cancelling a £1 billion London discovery expansion and AstraZeneca pausing a £200 million Cambridge development, signaling a broader retreat from UK commitments.

Medicine Launches Hampered: 46 Treatments Affected

The report documents profound impacts on medicine launches, with 46 innovative treatments disrupted since January 2024: 18 delayed, 17 available only privately, 7 not launched in the UK at all, and 4 remaining uncertain. Notably, 96% required approval from NICE (National Institute for Health and Care Excellence) or SMC (Scottish Medicines Consortium), yet 100% were available in EU countries. Twenty percent of companies' 2024-2025 pipelines were negatively affected, leaving 10% unavailable to NHS patients.

Areas hit hardest include oncology (lung, ovarian, prostate, breast cancers), rare diseases, cardiovascular, and central nervous system (CNS) disorders—primarily new active substances or indications. Of 24 medicines facing viability issues, 9 were withdrawn from appraisal, with VPAG (Voluntary Scheme for Branded Medicines Pricing and Access) cited in 67% of cases. Over five years, 62% of firms reported the UK's launch sequencing position deteriorating, positioning it as a "second-wave market."

• Oncology therapies for advanced cancers delayed, limiting NHS access.
• Rare disease treatments shifted to private markets, exacerbating inequalities.
• Twenty-five percent of NICE appraisals in 2024/25 yielded non-positive outcomes (8% not recommended, 17% terminated).

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VPAG Clawbacks: The Primary Culprit Explained

At the heart of the uncertainty lies the VPAG, the Voluntary Scheme for Branded Medicines Pricing and Access—a negotiated agreement between the ABPI and the Department of Health and Social Care (DHSC) that sets discounts on branded medicines to control NHS spending. Rates exceeded 20% in two of the past three years, surging to ~23.5% for newer medicines in 2025 (a 50% or 7.6-point increase over forecasts), acting as a de facto levy eroding margins.

This volatility—announced late—forces in-year adjustments, compressing liquidity for R&D and trials. It influences 83% of headcount decisions (up from 61% mid-2025), 68% of launch sequencing, and 55% of firms rank VPAG reform as the top priority. Branded medicines spend fell 9-10% since 2014 despite 44% NHS budget growth, dropping to 5% of NHS expenditure from 7.8% in 2018.

Nine in ten companies identify VPAG and NICE as the dominant factors shaping operations, per the MIIS survey.

NICE Thresholds and Regulatory Hurdles

NICE evaluates medicines' cost-effectiveness using quality-adjusted life years (QALYs), with thresholds unchanged since 1999—eroded 48% in real terms to a midpoint of £25,000/QALY, 30% below UK GDP per capita and below global averages (£33,400). Ranked bottom-third internationally, this rigidity, combined with VPAG, creates a high-risk market. Thirty-eight percent prioritize NICE reform.

Geopolitical factors like US most-favoured-nation (MFN) pricing reference UK net prices, while slow uptake and regional access variations compound issues. As Tom Keith-Roach of AstraZeneca noted, "The NICE HTA [health technology assessment] threshold hasn’t changed since 1999 and makes it increasingly difficult to secure a business case for UK launches."

Photo by simon on Unsplash

Workforce Implications: 29% Expect Reductions in 2026

With medium and large firms accounting for 98% of 2025 FTEs (~30,000 jobs), 83% link VPAG to headcount decisions. Looking ahead, 29% anticipate reductions in 2026 versus 12% expecting growth, predominantly from larger employers. This threatens the sector's 125,000 high-skilled roles.

Explore resilient opportunities in higher ed research jobs and postdoc positions within life sciences.

Ripple Effects on University Research and Spinouts

The UK's academic prowess—boasting 16 of the world's top 100 life sciences and medicine universities—produced 399 pharmaceutical spinouts in 2024, more than any sector, fueling over $10 billion in VC from 2017-2024. However, declining industry investment jeopardizes this ecosystem. Reduced clinical trials (UK share 2.6% globally, phase III ranking 8th) limit university-NHS-industry collaborations, translational research, and funding for proof-of-concept.

Disinvestment diverts late-stage trials abroad, curtailing clinician involvement and patient access at research hubs like Oxford and Cambridge. As per ABPI submissions, sustained public R&D is vital for the 'triple helix' model. For career advice, see how to write a winning academic CV.

Patient and Economic Consequences

Patients face delayed access to 46 breakthrough therapies, particularly in oncology and rare diseases, worsening inequalities as private launches bypass the NHS. Reduced trials mean fewer opportunities for cutting-edge care. Economically, unaddressed trends risk £93 billion in lost GDP and £11 billion in R&D by 2033.

Government Response: UK-US Deal and Sector Plan

In December 2025, a UK-US Economic Prosperity Deal promised NICE threshold hikes to £30,000/QALY midpoint, VPAG caps at 15% for newer medicines, and spending targets (0.6% GDP on newer medicines, 12% total). The July 2025 Life Sciences Sector Plan commits £2 billion+ but drew mixed ABPI feedback for lacking pricing reforms.

Recommendations and Path Forward

The MIIS urges swift VPAG/NICE finalization, coherent pricing policies, and MIIS tracking. Reforms could restore competitiveness, unlocking growth.

• Cap VPAG at 15% for new medicines.
• Raise NICE thresholds and improve uptake.
• Enhance trial infrastructure to 150-day setup.
• Boost public R&D to G7 lead.

Professionals can pivot via UK academic jobs.

Photo by Wolfgang Hasselmann on Unsplash

2026 Outlook: Cautious Optimism Amid Reforms

While 29% foresee FTE cuts, positive signals like BIA's Q4 momentum, M&A surge (e.g., MSD-Verona £7.5bn), and policy shifts offer hope. Sustained action could reverse declines, bolstering university-led innovation. Stay informed and competitive—browse research jobs, higher ed jobs, and rate my professor for insights.