Helping improve patient outcomes and access to new medicines

Our expert team advises on commercial agreements for high cost and new drug purchases.

We advise a range of clients including NHS England when it enters into specialist and bespoke commercial arrangements relating to new and innovative high cost treatments that are not in routine commissioning.

These highly confidential commercial arrangements allow our clients to make the best possible treatments available to patients across the country whilst still delivering value for money. Pharmaceutical companies are also able to benefit from access to the world’s largest publicly funded health service.

Main areas of practice

Our team regularly advises on commercial agreements for high cost and new drug purchases in the following areas:

Budget impact test (BIT)

If the budget impact of a new drug exceeds NICE's threshold of £20 million, in any of the first three years, NHS England may engage in commercial discussions with the company. These discussions are designed to mitigate the impact that funding the technology would have on the rest of the NHS.

Highly specialised technologies (HST)

HST are recommendations by NICE on the use of new and existing highly specialised medicines and treatments within the NHS in England. These medicines are often very high cost, low volume treatments where NHS England needs to enter into confidential commercial arrangements with the company in order to be able to make the treatments available to patients whilst delivering value for money to the NHS.

The 2024 Voluntary Scheme for Branded Medicines Pricing, Access and Growth

The Voluntary Scheme for Branded Medicines Pricing, Access and Growth (VPAG) is the overarching agreement on pricing for branded medicines supplied to NHS hospitals across the UK. We have advised NHS England’s Medicines Procurement and Supply Chain team on the terms of VPAG and the preceding 2019 agreement. The deal reached means that VPAG will secure twice the level of savings of the scheme which it replaces, amounting to some £14bn in savings against list prices of medicines.

Our clients

Our expert team specialising in high cost and new drug procurement primarily advises the Specialised Commissioning Team within NHS England.

Awards, accolades and accreditations

Blake Morgan is able to provide decisive advice to complex legal matters or dilemmas.
- Chambers and Partners, 2026

Blake Morgan provides excellent service.
- Chambers and Partners, 2025

Highlights

Advising the Specialised Commissioning Team at NHS England on the first commercial agreements to be entered into under the new VPAS scheme.

Advising the Team on implementing a multi-company commercial agreement process to allow for more combination therapies to be offered by the NHS and advising on the updated and streamlined BIT Commercial Agreement contracts and process.

Assisting the Team in carrying out a full review of the existing Commercial Agreement process following the increased scope of VPAS in comparison to the previous PPRS scheme.

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