The UK government has ended negotiations with pharmaceutical companies over a new drug pricing scheme for the National Health Service (NHS), following a private ultimatum from the health secretary demanding acceptance of the government’s latest offer by Friday. The talks collapsed primarily because the pharmaceutical industry refused to lower the proposed discount rate in the rebate scheme. This impasse has raised concerns about the future of pharmaceutical investment in the UK, with AstraZeneca’s UK president stating that it is increasingly difficult to promote the country as a hub for investment and research due to challenges in bringing innovation to patients. Industry representatives have warned that without increased NHS spending on drugs, major pharmaceutical companies may withdraw investment and jobs from the UK. The breakdown in talks threatens to extend a period of high rebates on medicines for another year, potentially impacting access to new treatments. Meanwhile, the European Medicines Agency (EMA) is reportedly learning from US-inspired regulatory streamlining efforts, but the UK’s drug pricing dispute underscores ongoing tensions between government cost controls and pharmaceutical industry demands.