GSK’s Emma Walmsley Hails US as ‘Best Place to Invest’ as UK Pharma Faces Tariffs, Rebate Cuts and a Fight for Jobs

On 11 December 2025, outgoing GSK chief executive Dame Emma Walmsley sent a stark message to Westminster and the City: for big drug makers, the United States is now the premier destination for investment – and Britain is at risk of slipping further behind.

In a broadcast interview, Walmsley praised the US as the world’s most attractive market for new medicines, saying it remains the leading arena for launching innovative drugs and vaccines and the “best place to invest” for global pharma. She also pointed to China as the other key growth market for business development. ^[1]

Her comments land just as the UK government unveils a complex package of measures – including a new UK‑US zero‑tariff deal on medicines and a sharp cut in the controversial NHS “clawback” on drug sales – designed to stop pharmaceutical investment draining away from Britain. ^[2]

Walmsley backs America as GSK’s investment priority

Dame Emma Walmsley is due to step down in January after eight years at the helm of London‑listed GSK, one of the UK’s flagship life sciences companies. ^[3]

In her latest remarks, she:

Reaffirmed that GSK “won’t shy away” from prioritising the US, where the company already generates around half its revenue. ^[4]
Argued that the US remains the global leader in launching new drugs and vaccines and offers the strongest environment for commercialising innovation. ^[5]
Identified China – alongside the US – as the best market in which to strike business development and partnership deals. ^[6]

GSK has already backed up that rhetoric with hard numbers. In September the company committed to investing about $30 billion (£23 billion) in the US by 2030, targeting manufacturing capacity, R&D sites and new product launches over the next five years. ^[7]

Walmsley’s support for America mirrors similar moves by AstraZeneca, whose chief executive Pascal Soriot has repeatedly talked up the “vital importance” of the US and announced plans to invest $50 billion there by 2030. ^[8]

A warning shot for Britain’s ‘crown jewel’ sector

Walmsley’s remarks are not an isolated soundbite; they sit on top of a growing list of painful decisions by major drug makers to scale back or shelve UK projects:

Merck (MSD) has scrapped a planned £1 billion Discovery Centre at London’s King’s Cross and is cutting about 125 science jobs in the capital, citing a hostile business environment and the UK’s tendency to undervalue innovative medicines. ^[9]
AstraZeneca has paused a £200 million expansion of its Cambridge Discovery Centre, saying none of its previously announced new UK funding is currently moving ahead. ^[10]
AstraZeneca and other companies have instead announced large US investments, betting on a more predictable pricing environment and stronger returns on R&D. ^[11]

These decisions are especially uncomfortable for a UK government that has branded life sciences one of the “crown jewels” of the economy and previously set out ambitions to become a “science and technology superpower”. ^[12]

Walmsley’s endorsement of US over UK investment, coming from the outgoing head of a FTSE‑listed champion, underlines how far Britain’s competitive position has eroded in the eyes of global pharma boards.

The UK–US zero‑tariff deal: more drugs, higher bills

Behind the scenes, London and Washington have been racing to defuse a confrontation over tariffs on medicines triggered by US President Donald Trump’s push to “re‑shore” drug manufacturing and cut what he views as unfair pricing by other rich countries.

Trump has lashed out at European systems for paying less for medicines while US patients shoulder more of the cost, and has introduced steep tariffs on branded drugs manufactured abroad to pressure companies to invest domestically. ^[13]

To shield British pharmaceutical exports from these measures, the UK has now struck a dedicated pharma agreement with the US which, in broad terms, offers:

Zero tariffs on UK pharmaceutical exports to the US – worth at least £5 billion a year – for a period currently expected to run until 2028. ^[14]
A pledge to increase NHS spending on medicines by about £1.5 billion over three years, lifting drugs spending from roughly 0.3% to 0.35% of GDP by 2028, with a longer‑term ambition to reach 0.6% by 2035. ^[15]

UK ministers argue the deal protects high‑value export jobs and reinforces the country’s life sciences brand, while also speeding up access to cutting‑edge medicines for NHS patients.

Critics, however, note that the extra spending on drugs is not backed by new money from the Treasury. Instead, they warn, it will squeeze other parts of an already stretched health service – from staffing to diagnostic equipment and community care – if overall NHS budgets are not increased accordingly. ^[16]

Cutting the NHS ‘clawback’: VPAG’s rebate rate falls to 14.5%

The other key piece of the puzzle is the UK’s Voluntary Scheme for Branded Medicines Pricing, Access and Growth (VPAG). Under VPAG, drug companies selling branded medicines to the NHS must rebate a percentage of their revenue back to the government once spending rises above an agreed growth cap.

That repayment rate has been a major flashpoint:

This year, companies have been handing over about 22.9% of sales on newer medicines – a level industry groups say is out of line with peer countries and makes Britain an unattractive launch market. ^[17]
On 10–11 December, the government confirmed that the 2026 payment rate will drop to 14.5%, more than a one‑third cut, thanks in part to a slowdown in the growth of NHS spending on new treatments. ^[18]

Crucially, that 14.5% figure sits just below the 15% upper limit envisaged in the UK–US tariff deal. In other words, the new agreement has effectively capped how punishing the rebate can be in coming years – at least while the current VPAG framework is in place. ^[19]

Industry response has been cautiously positive. The Association of the British Pharmaceutical Industry (ABPI) welcomed the lower rate and the prospect of more predictable payment caps over the next three years, but stressed that:

UK payment rates are still higher than in comparable countries, and
The NHS remains slow to adopt many cost‑effective treatments, limiting real‑world access even when drugs are technically approved. ^[20]

ABPI chief Richard Torbett has framed the change as a necessary “first step” rather than a full solution to Britain’s competitiveness problem. ^[21]

NICE gets more flexibility – and ministers more power

A second part of the reforms focuses on NICE, the National Institute for Health and Care Excellence, which decides whether new medicines are value for money for the NHS.

Under proposals linked to the UK–US deal and published this week:

NICE will raise the cost‑effectiveness threshold – the maximum cost per quality‑adjusted life year (QALY) it is normally willing to pay – making it easier for expensive drugs, such as advanced cancer therapies or rare disease treatments, to pass the test. ^[22]
For the first time, UK ministers could be given limited powers to adjust that threshold directly through secondary legislation, rather than leaving it entirely to NICE’s technocratic process. ^[23]

Supporters say this will help Britain keep pace with medical innovation and reflect broader industrial‑strategy aims, not just short‑term budget constraints.

Sceptics worry it could politicise decisions about which drugs the NHS funds and open the door to lobbying pressure – especially if changes in the threshold are presented as part of trade negotiations or wider diplomatic deals. ^[24]

New working group: pharma and ministers to design a post‑VPAG world

VPAG itself is due to expire in around three years. According to reports, Whitehall officials are now setting up a new joint working group that will bring together ministers and senior executives from companies including AstraZeneca and GSK to devise the next generation of UK drug‑pricing rules. ^[25]

Options under discussion are understood to include:

Outcome‑based pricing, where what the NHS pays depends on how well a treatment works in practice.
Linking drug prices more explicitly to the amount of R&D and manufacturing a company carries out on UK soil, to encourage investment and high‑skilled jobs. ^[26]

The government insists the US tariff deal and the new pricing framework will “enable and incentivise” life sciences companies to keep investing and innovating in Britain, even as firms continue to pour money into American facilities. ^[27]

Why the US still wins on returns and regulation

Despite recent UK concessions, Walmsley’s assessment reflects structural advantages that the US continues to enjoy in the eyes of multinational drug makers:

Scale and pricing power
The US remains the single largest pharmaceuticals market, with historically higher prices than most European systems, giving companies greater scope to recoup billion‑dollar development costs. ^[28]
Faster uptake of new medicines
Once a drug is approved, US uptake is typically far quicker than in the UK, where commissioning processes, local budget pressures and cautious guidelines can delay widespread use even after NICE approval. ^[29]
Policy pressure to invest domestically
Trump’s tariff strategy – including triple‑digit tariffs on some imported branded drugs – has materially changed the calculus for manufacturing and R&D location decisions, pushing companies to expand US plants and labs to avoid trade penalties. ^[30]
Regulatory and capital‑markets ecosystem
Deep US capital markets, a dense biotech cluster and an FDA that many companies see as predictable for big blockbuster launches all reinforce the incentive to concentrate pipeline assets there. AstraZeneca’s decision to upgrade its US listing, for example, was widely read as another signal of American financial appeal. ^[31]

Against that backdrop, UK policies need to be not just “good enough” but genuinely compelling to persuade global boards to allocate scarce capital back towards Britain.

What this means for UK patients, workers and investors

For patients, the new arrangements are a double‑edged sword:

Potential upside
- Higher medicine budgets and a more generous NICE threshold should, in principle, mean faster access to high‑cost treatments in areas like oncology, rare disease and advanced biologics. ^[32]
Potential downside
- If the extra drug spending is financed from within existing NHS budgets, there is a risk it comes at the expense of staffing, diagnostics and other frontline services that are critical to patient outcomes. ^[33]

For workers and regional economies, the stakes are equally high. The scrapping of Merck’s London research centre and the pause in AstraZeneca’s Cambridge expansion have already cost or jeopardised hundreds of highly skilled jobs and weakened the case for new lab clusters around those hubs. ^[34]

Conversely, the tens of billions of dollars GSK and AstraZeneca are channelling into US sites will create thousands of roles across manufacturing, clinical development, data science and advanced engineering – roles that might otherwise have been anchored partly in the UK. ^[35]

For investors, Walmsley’s comments underscore a broader trend: large-cap pharma is increasingly treating the US not just as its biggest market, but as its primary base for incremental capital spending. That may bolster earnings visibility for US‑exposed giants – but it raises tough questions about the long‑term growth prospects of UK‑centric life sciences and the depth of Britain’s biotech ecosystem.

Key questions to watch after 11 December 2025

As the dust settles on this week’s announcements, several big questions will shape how the story unfolds:

Will the 14.5% VPAG rate be low enough to tempt companies to restart shelved UK projects, or will it be seen as still too high versus competitor countries? ^[36]
Can the new UK–US deal survive political scrutiny on both sides of the Atlantic – particularly if NHS waiting lists or costs become more contentious in Westminster? ^[37]
How far will ministers go in using their new powers over NICE thresholds, and will those decisions be guided by clinical value or diplomatic and industrial‑strategy considerations? ^[38]
Will GSK’s next chief executive stick with Walmsley’s US‑first strategy, or try to rebalance investment towards the UK and Europe if conditions improve? ^[39]
Can the new pricing working group design a post‑VPAG regime that keeps the NHS sustainable while making Britain genuinely attractive again for breakthrough drug launches and advanced manufacturing? ^[40]

For now, Walmsley’s verdict is clear – and it will echo in boardrooms well beyond GSK. On 11 December 2025, she put it bluntly: the US is where big pharma sees the best prospects for its money. Whether the UK can change that perception in the next three years may determine the future shape of its entire life sciences economy.