Reconfiguring Pharmaceutical Competitiveness in the Post-Brexit Era: A Comparative Analysis of the UK and European Union
Main Article Content
Abstract
Objective: To compare pharmaceutical competitiveness in the United Kingdom (UK) and European Union (EU) after Brexit, with emphasis on regulatory pathways, marketing authorisation, medicine access, innovation, industry operations, and regulatory divergence.
Methods: A comparative descriptive approach was used on secondary data from official sources including the Medicines and Healthcare products Regulatory Agency (MHRA), European Medicines Agency (EMA), European Commission, and scientific literature. Pre-Brexit and post-Brexit regulatory systems were assessed using indicators such as marketing authorisation routes, approval timelines, reliance procedures, clinical-trial requirements, pharmacovigilance, market access, and industry trends. Comparative and trend analyses were conducted to identify changes in regulatory performance and competitiveness.
Results: The findings showed greater regulatory separation between the UK and EU after Brexit. The UK established an independent, MHRA-led framework incorporating national and reliance-based pathways, while the EU maintained its centralised and coordinated regulatory system. This divergence created additional administrative, documentation, compliance, and market-entry requirements for companies operating in both jurisdictions. However, UK reforms also introduced greater flexibility and opportunities for streamlined assessment in certain situations. Differences emerged in approval procedures, clinical-trial regulation, pharmacovigilance obligations, and market-access strategies. The EU retained the advantages of regulatory integration across member states, whereas the UK gained greater regulatory autonomy.
Conclusion: Brexit has reshaped pharmaceutical competitiveness by creating a balance between regulatory independence and the advantages of harmonisation. Continued UK–EU cooperation, reliance mechanisms, regulatory convergence, and international harmonisation could reduce duplication, improve efficiency, support timely medicine access, and promote innovation in both pharmaceutical markets
Article Details

This work is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License.
References
Hofer, M. P., Criscuolo, P., Shah, N., Ter Wal, A. L. J., & Barlow, J. (2022). Regulatory policy and pharmaceutical innovation in the United Kingdom after Brexit: Initial insights. Frontiers in Medicine, 9, 1011082.
https://doi.org/10.3389/fmed.2022.1011082
Wouters, O. J., Hervey, T., & McKee, M. (2020). Brexit and the European Medicines Agency—What next for the agency and UK drug regulators? JAMA Health Forum, 1(2), e200135. https://doi.org/10.1001/jamahealthforum.2020.0135
House of Commons Health and Social Care Committee. (2018). Brexit: Medicines, medical devices and substances of human origin (Fourth Report of Session 2017–19, HC 392). UK Parliament. https://publications.parliament.uk/pa/cm201719/cmselect/cmhealth/392/392.pdf
House of Commons Business, Energy and Industrial Strategy Committee. (2018). The impact of Brexit on the pharmaceutical sector (Ninth Report of Session 2017–19, HC 382). UK Parliament. https://publications.parliament.uk/pa/cm201719/cmselect/cmbeis/382/382.pdf
Kamphuis, B., Fontrier, A.-M., Efthymiadou, O., Gill, J., Salyga, H., & Kanavos, P. (2021). Access to medicines in Europe: Delays and challenges for timely patient access. LSE Consulting, London School of Economics and Political Science. https://www.lse.ac.uk/business/consulting/assets/documents/Access-to-medicines-in-Europe-Final-Report.pdf
Breckenridge, A., & Feldschreiber, P. (2018). Impact of Brexit on UK and EU drug regulation and patient access. Clinical Pharmacology & Therapeutics, 104(6), 1019–1021. https://doi.org/10.1002/cpt.1261
Jackson, E., Feldschreiber, P., & Breckenridge, A. (2017). Regulatory consequences of “Brexit” for the development of medicinal products. Clinical Pharmacology & Therapeutics, 102(5), 687–690.
https://doi.org/10.1002/cpt.706
Aitken, M., Kleinrock, M., Muñoz, E., & other authors. (2018). The impact of Brexit on pharmaceuticals and health technology assessment. Value in Health, 21(6), 677–684. https://doi.org/10.1016/j.jval.2018.03.009
Galsworthy, M. J., Irwin, R., & McKee, M. (2017). Brexit and the UK pharmaceutical industry: Risks and opportunities. The Lancet, 389(10074), 2187–2189.
https://doi.org/10.1016/S0140-6736(17)31294-4
Dayan, M., Hervey, T., Fahy, N., Vlachakis, E., McCarey, M., Flear, M., et al. (2023). Parallel, divergent or drifting? Regulating healthcare products in a post-Brexit UK. Journal of European Public Policy, 30(11), 2540–2572.
https://doi.org/10.1080/13501763.2023.2213721
Hervey, T. K., Young, C., & Bishop, L. (2017). Brexit: Implications for health and social care. Nuffield Trust.
Fahy, N., & Hervey, T. (2017). Brexit and the NHS: Health law and regulation. Medical Law Review, 25(4), 666–676.
https://doi.org/10.1093/medlaw/fwx033
Greer, S. L., Bekker, M., Azzopardi-Muscat, N., & McKee, M. (2018). The Brexit effect on health and health care in the UK. European Journal of Public Health, 28(Suppl. 3), 8–9. https://doi.org/10.1093/eurpub/cky173
Wouters, O. J., McKee, M., & Luyten, J. (2017). Estimated research and development investment in the pharmaceutical industry in the United Kingdom following Brexit. BMJ, 356, j177.
https://doi.org/10.1136/bmj.j177
Green, D. G. (2017). Brexit and the pharmaceutical industry: Regulatory and economic implications. Journal of Pharmaceutical Health Services Research, 8(3), 137–140.
Breckenridge, A., & Feldschreiber, P. (2019). Impact of Brexit on UK and EU drug regulation and patient access. Clinical Pharmacology & Therapeutics, 105(4), 923–925. https://doi.org/10.1002/cpt.1261
Gøtzsche, P. C. (2017). Brexit and the regulation of medicines: Consequences for patients and public health. BMJ, 357, j2085.
https://doi.org/10.1136/bmj.j2085
Williams, S., & Robinson, A. (2018). Brexit and the regulation of medicines: Maintaining safety, quality and access. British Journal of Clinical Pharmacology, 84(9), 1984–1987.
Lythgoe, M. P., Middleton, M. R., Savage, L., et al. (2021). From the European Medicines Agency to Project Orbis: Regulatory transformation in the UK after Brexit. The Lancet Oncology, 22(2), e59–e60.
European Medicines Agency. (2025). Brexit-related guidance for companies. https://www.ema.europa.eu/en/about-us/history-ema/brexit-united-kingdoms-withdrawal-european-union/brexit-related-guidance-companies
European Medicines Agency. (2021). Notice to stakeholders: Withdrawal of the United Kingdom and EU rules for medicinal products for human use and veterinary medicinal products. https://www.ema.europa.eu/en/documents/regulatory-procedural-guideline/notice-stakeholders-withdrawal-united-kingdom-and-eu-rules-medicinal-products-human-use-and-veterinary-medicinal-products_en.pdf
Medicines and Healthcare products Regulatory Agency. (2025). International Recognition Procedure. GOV.UK. https://www.gov.uk/government/publications/international-recognition-procedure/international-recognition-procedure
Medicines and Healthcare products Regulatory Agency. (n.d.). Guidance on the regulation of medicines, medical devices and clinical trials following Brexit. GOV.UK. https://www.gov.uk/government/organisations/medicines-and-healthcare-products-regulatory-agency
European Medicines Agency. (2025). Clinical Trials Regulation. https://www.ema.europa.eu/en/human-regulatory-overview/research-development/clinical-trials-human-medicines/clinical-trials-regulation
European Medicines Agency. (2025). Clinical Trials Information System (CTIS). https://www.ema.europa.eu/en/human-regulatory-overview/research-development/clinical-trials-human-medicines/clinical-trials-information-system
European Parliament & Council of the European Union. (2014). Regulation (EU) No 536/2014 on clinical trials on medicinal products for human use, and repealing Directive 2001/20/EC. https://health.ec.europa.eu/medicinal-products/clinical-trials/clinical-trials-regulation-eu-no-5362014_en
Organisation for Economic Co-operation and Development. (2025). OECD health statistics: Pharmaceutical expenditure and research and development indicators. OECD. https://www.oecd.org/en/data/datasets/oecd-health-statistics.html
Steadman, K., et al. (2018). The consequences of “Brexit” for drug discovery and development, and the regulatory implications. Drug Discovery Today, 23(7), 1250–1252. https://doi.org/10.1016/j.drudis.2018.04.008
Barlow, J., et al. (2020). The impact of Brexit on the pharmaceutical supply chain of the United Kingdom: Scoping review protocol. Journal of Pharmaceutical Policy and Practice, 13, 45. https://doi.org/10.1186/s40545-020-00245-3
Barlow, J., et al. (2021). The impact of Brexit on the pharmaceutical supply chain of the United Kingdom: A scoping review. Journal of Pharmaceutical Policy and Practice, 14, 57.
Fitzgerald, D., Hinterberger, A., Narayan, J., & Williams, R. (2020). Brexit as heredity redux: Imperialism, biomedicine and the NHS in Britain. Sociological Research Online, 25(4), 635–655.
https://doi.org/10.1177/0038026120914177
Flear, M. L., et al. (2021). Challenges to sovereign ambitions: Forces of convergence and divergence within the global pharmaceutical sector and the UK’s withdrawal from the European Union. Journal of Law and Society, 48(3), 368–394.
Kazzazi, F., Pollard, C., Tern, P., Ayuso-Garcia, A., Gillespie, J., & Thomsen, I. (2017). Evaluating the impact of Brexit on the pharmaceutical industry. Journal of Pharmaceutical Policy and Practice, 10, 32.
https://doi.org/10.1186/s40545-017-0120-z
Barnett, A., Vasileiou, K., Djemil, F., Brooks, L., & Harris, M. (2023). Understanding innovators’ experiences of the UK medicines regulatory system after Brexit. Pharmaceutical Medicine, 37(4), 225–235.
Kanavos, P., Tzoulea, E., & Papanicolas, I. (2018). “Pharmaceutical pricing and reimbursement after Brexit: Implications for market access.” Health Policy, 122(8), 832–838.