Research and analysis

Life sciences competitiveness indicators 2024: summary

Published 11 July 2024

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Summary of the UK’s performance in the LSCIs

Figure 1: The UK’s position amongst comparator countries (in terms of quartiles) for metrics in each section of the life sciences ecosystem

Figure 1 above shows the UK’s position amongst comparator countries (in terms of quartiles) for metrics in each section of the life sciences ecosystem.

Notes:

  • Each square represents an individual metric
  • Metrics for which no ranking is available are coloured grey
  • The colour of each square represents the UK’s quartile position amongst comparator countries only (rather than all countries).
  • Top quartile = the UK sits within the top quartile (25th percentile) of comparator countries.
  • Middle quartiles = the UK sits within the middle quartiles (between the 25 and 75 percentiles) of comparator countries.
  • Bottom quartile = the UK sites within the bottom quartile (75th percentile) of comparator countries.

Main points on the UK’s performance in the LSCIs

Research environment

  • The UK continues to have the second highest budget allocation for health research and development as a percentage of gross domestic product (GDP) amongst comparator countries, behind only the USA. The budget allocation made up 0.13% of GDP in 2021, a decline from 0.15% in 2020. Similar declines were seen over the same period in countries such as the USA, France and Japan.

  • £9.0 billion of pharmaceutical R&D was performed by the business enterprise sector in 2022, which was equivalent to 0.36% of the UK’s GDP. Pharmaceutical R&D accounted for 18% of all R&D performed by businesses in the UK in 2022, the highest of any product area.

  • In 2022, the UK’s global share of patients recruited to a subset of commercial trials was 2.6%, a notable increase from 2.2% in 2021 which resulted in the UK’s ranking rising from fifth to fourth amongst comparator countries. The median length of time to approve and set-up clinical trials in 2022 remained similar to 2021, following a period of year-on-year increases between 2018 and 2021. Despite there being little change in the UK’s median length of time to approve and set up clinical trials between 2021 and 2022, the UK’s ranking amongst comparator countries increased from ninth in 2021 to eighth in 2022.

  • The UK continues to account for a substantial share of global medical sciences citations, at 11.5% in 2023, behind only the USA and China. The UK was also one of the leaders in producing high quality academic research in medical sciences amongst comparators; 1.8% of publications were considered highly cited, which was the largest percentage of all comparator countries and similar to the percentages seen in France, Italy and Germany.

  • The UK had 0.14 patent applications per thousand population in 2021 and has seen a broadly consistent trend since 2011. This ranked the UK fifth out of comparator countries, a ranking which has also remained broadly stable over the same period.

Domestic market

  • For medicines that received marketing authorisation between 2019 and 2022, 56% and 54% were available to patients in England and Scotland respectively.  This resulted in England ranking seventh and Scotland ninth out of 13 comparator countries. This percentage has declined compared to the previous period, but this trend was also seen in most other European comparators.

  • The median length of time for medicines approved between 2019 and 2022 to be made available to patients was 299 days in England and 313 days in Scotland. The median time ranges vastly across Europe but both England and Scotland place in the top half of countries at fifth and sixth respectively out of 13 comparators.

  • The median uptake of medicines launched between 2018 and 2022 in the UK continues to be lower than the average of competitors between 1 year after launch through to 5 years after launch. The uptake ratio was 0.52 1 year after launch, meaning average uptake was around half the comparator average for this period, but increased to 0.62 5 years after launch.

Production environment

  • Pharmaceutical manufacturing gross value added (GVA) in the UK reached £13.7 billion in 2021 (in chained volume measures, and rebased into 2015 prices),  the highest value seen during the entire period between 2013 and 2021, with a continuous upward trend seen since 2017.

International collaboration

  • The value of UK pharmaceutical exports has recovered slightly from the decline seen between 2017 and 2021, with notably higher values in 2022 and 2023 than in 2021. Despite this rise, the UK’s ranking against comparators remained at tenth in 2023, with a value of £25.6 billion for pharmaceutical exports.
  • After a period of growth between 2013 and 2019, the value of medical technology exports has remained stable for the UK. In 2023, the UK ranked eleventh amongst comparator countries, with an export value of £10.1 billion.
  • The value of pharmaceutical imports saw a notable drop between 2022 and 2023, decreasing by 18% to £24.9 billion, meaning that the UK moved down from ninth to tenth amongst comparator countries.
  • The value of medical technology imports continued to decrease in 2023 from the spike seen in 2020, though remains higher than the import values seen pre-pandemic. The value of imports reached £15.5 billion in 2023, ranking the UK sixth against comparators.

Investment environment

  • The UK saw a further drop in the estimated value of inward life sciences foreign direct investment (FDI) in 2023, marking the second year-on-year decline since 2021 and ranking the UK eighth compared to comparators. Inward investment into the UK in 2023 was £0.8 billion, a 21% drop compared to 2022. Other comparators also saw notable declines in 2023 such as the USA and Ireland.

  • Equity finance raised by the UK life sciences sector similarly dropped in 2023, following a previous drop in 2022 from 2021. Equity finance raised in 2023 fell to £2.9 billion, a 14% decrease compared to 2022. Similar decreases were also seen in most comparator countries and as a result, the UK ranked third against comparators in 2023, up from fourth in 2022 and behind only the USA and China.

  • There were no life sciences initial public offerings (IPOs), a type of equity finance, in the UK in 2023. Similar to other forms of investments, the number of IPOs has declined from 9 in 2021 - many other countries have seen similar downward trends such as France and Canada, where there were also no IPOs in 2023. The USA and China also saw a decline in the number of IPOs since 2021, but they remained at the top of the rankings alongside India despite this.
  • Investments can be highly volatile year-on-year and surges were seen over 2020 and 2021 to accelerate research into COVID-19 over the course of the pandemic.

Access to skilled labour

  • In 2021, 8.7% of UK graduates from a tertiary education graduated from natural sciences, mathematics and statistics programmes; this placed the UK second amongst comparators, behind only India. However, the UK has seen a declining proportion of graduates choosing these fields since 2019, when 13.4% of graduates completed degrees in these fields.

Introduction

The Life sciences competitiveness indicators (LSCIs) are a set of high-level indicators used to measure the performance of the UK’s life sciences sector by benchmarking the UK in relation to comparator countries. The indicators are brought together from a range of different sources, including data already in the public domain, and commercially sourced data published for the first time via this report.

2024 publication updates

The LSCIs are published each year as part of a collection of ‘research and analysis’ reports. From the 2024 report and onwards, OLS are committing to a voluntary application of the Code of Practice for Statistics in the compilation and dissemination of these reports. This is to provide users with further information on the standards of the data and processes used in the LSCIs. This year’s report is accompanied by a statement on voluntary application which outlines where the LSCIs applies principles from the code and highlights places where there are deviations or proposals for improvement in the longer term.

The 2024 collection for the LSCIs reports on the same metrics as the previous 2023 report, where data availability allows. A summary of notable changes in the reporting for 2024 is below:

  • New data for the metric ‘gross domestic expenditure on medical and health sciences R&D performed by the higher education sector as a percentage of GDP’ is not reported in this year’s LSCIs due to the fact that recent data is unavailable for the UK. This is because there has been a change in the data source used by ONS to provide data on the UK to OECD, which has resulted in UK higher education R&D expenditure data being unavailable for 2018 onwards.

  • The Office for National Statistics have carried out methodological developments on their business enterprise research and development (BERD) statistics, which have resulted in a large uplift in the value of expenditure on pharmaceuticals R&D performed by UK businesses that was reported in previous LSCIs publications. These methodological developments caused a discontinuity in the timeseries, so ONS have presented BERD pharmaceutical R&D data for 2022 only as of June 2024.

  • The data source for the metrics on exports and imports of pharmaceutical and medical technology products has changed in this year’s publication. This data is now extracted from UN Comtrade instead of UNCTAD (the source used in previous years), meaning that it has been possible to obtain data using a more granular and comprehensive selection of commodities relating to the life sciences sector. The result of this change has been that coverage of the sector’s trade in goods has been improved, and the breadth of medical technology products in particular is now captured more fully. This has had minimal impact on the UK’s positioning compared to other countries.

  • Since the UK is no longer part of Eurostat’s data collection, it has been necessary to find a new data source for pharmaceuticals and medical technology manufacturing employment. OECD data on employment by economic activity has been used to replace Eurostat data for pharmaceuticals employment, but this data is not sufficiently granular to provide equivalent data on medical technology employment. As a result, the metric on medical technology manufacturing employment has been omitted from this publication - OLS will continue to search for a suitable data source to provide this data in the future.

Accompanying documents

 This report is part of a series of documents for the 2024 LSCIs publication:

Other sources of UK life sciences data

The LSCIs aim to compare the UK’s life sciences sector to other countries by using the most suitable sources available. There are frequently alternative sources for measuring aspects of the UK life sciences sector but a standardised view for other countries is not available to make a comparison. The accompanying user guide provides further details on where there are deviations from other available data sources for the UK.

The OLS also produces the annual bioscience and health technology sector statistics, which provides a comprehensive view on the size and composition of the UK life sciences sector. This is recommended to be used for any figures on the number of businesses, sites and turnover for the UK sector when an international comparison is not needed.

Feedback

The Office for Life Sciences (OLS) will continue to review the publication content on an annual basis to ensure it continuously meets evolving user needs.

OLS is looking to expand its list of known users of the LSCIs reports. If you use any aspects of the LSCI collection and wish to be involved in regular updates/feed in views on the publication, please get in touch with [email protected]

Section 1: Research Environment

Research and development (R&D)

R&D can be measured by the expenditure on R&D performed by an organisation, or the amount of R&D funded by the organisation. Funding received to perform R&D can come from the organisation itself, organisations within the same sector or a separate sector of the economy.

More information on the flows between R&D funded and performed in the UK can be found in the Office for National Statistics publication on Gross Domestic Expenditure on R&D, covering R&D across all industries in the UK.

The LSCIs measure the amount of R&D relevant to life sciences performed by government, higher education, private non-profit, and business sectors. However, it should be noted that the R&D figures presented here are not comprehensive of all life sciences R&D due to data availability. Government budget allocations are also included, as this has less of a time lag and can provide early insight into R&D performance for sectors highly reliant on government funding, such as higher education.

The UK is not currently reporting recent figures for amount of medical and health sciences R&D performed by the higher education sector and this is therefore unavailable in this year’s report. More information is available in the life sciences competitiveness indicators 2024: user guide. 

The Office for National Statistics have carried out methodological developments on their business enterprise research and development (BERD) statistics, which have resulted in a substantial uplift in the value of expenditure on pharmaceuticals R&D performed by UK businesses that was previously reported in this publication. In the 2022 LSCIs publication, it was reported that the value of pharmaceuticals R&D performed by UK industry was £5.0 billion in 2020, which accounted for 19% of the total spend on R&D performed by UK businesses. Using the latest data from ONS, which was collated under the new methodology, the value of pharmaceuticals R&D performed by UK industry in 2022 was £9.0 billion (but due to the uplift across all areas, pharmaceuticals still accounts for a similar proportion (18%) of the total R&D spend). These methodological developments caused a discontinuity in the time series, so only 2022 data is available as of June 2024. ONS are seeking to produce a time series with comparable estimates across time periods in the near future – please read ONS’s latest BERD publication page for more information.

Government budget allocations for Health R&D

The UK Government budget for health R&D declined slightly in 2021 compared to 2020 but remains higher than levels seen between 2015 and 2019.

Figure 2: Government budget allocations for health R&D as a percentage of GDP

Figure 2 above shows government budget allocations for health R&D as a percentage of GDP.

Notes:

In 2021, the UK Government’s budget for health R&D was £2.9 billion, which equated to 0.13% as a percentage of GDP. This ranked the UK second out of all comparator countries for the most recent data available (2022 for all countries except the UK, Australia, South Korea and Canada) in terms of the proportion of GDP, behind only the USA. The UK has consistently held this ranking every year since 2015.

The UK’s health budget as a percentage of GDP dropped from 0.15% in 2020 to 0.13% in 2021. The total budget for health R&D fell from £3.2 billion in 2020 to £2.9 billion in 2021, a relative decline of 8% (not adjusted for inflation). A number of other comparator countries, such as the USA, Italy, France and Japan, also saw declines over the same period.

The USA’s budget as a proportion of GDP has consistently been the highest of all comparator countries. This proportion increased between 2015 and 2020 but subsequently decreased from 0.23% in 2020 to 0.18% in 2022, with the USA’s budget as a proportion of GDP in 2022 being similar to that seen in 2015.

Gross domestic expenditure on R&D for government and the private non-profit sector

The UK Government performed a lower proportion of R&D compared to comparators whilst the private non-profit sector placed around the centre of the rankings.

Figure 3: Gross domestic expenditure on medical and health sciences R&D performed by government and higher education sectors and all R&D for the private non-profit sector, as a percentage of GDP for 2021 or latest year available

Figure 3 above shows gross domestic expenditure on medical and health sciences R&D performed by government and higher education sectors and all R&D for the private non-profit sector, as a percentage of GDP for 2021 or latest year available.

Notes:

  • Data from figure 3 can be found in tables 2-3 of the accompanying ‘life sciences competitiveness indicators 2024: data tables’.
  • Figures for R&D performed by government relate to medical and health science R&D. For the private non-profit sector this relates to all R&D performed.
  • The data labels in the chart are rounded to 2 decimal places but the bars represent their unrounded value.
  • Figures where R&D as a percentage of GDP rounds to 0 at 2 decimal places are not included in the visualisation.

In 2021:

  • UK Government institutions performed £160 million of medical and health sciences R&D, amounting to 0.01% of GDP. This was lower than most comparators, with countries such as Spain and Germany spending the equivalent of 0.08% and 0.06% of their GDP respectively on medical and health sciences R&D in 2021.
  • The value of expenditure on R&D performed by the UK private non-profit sector was £973 million, or 0.04% as a percentage of GDP, which placed the UK in the middle of the ranking of comparators. This measure includes all R&D by the private non-profit sector. In the UK, the private non-profit sector largely consists of registered charities and trusts that specialise mainly in health and medical research, but this is not necessarily the case in other countries, where private non-profit sector R&D figures may include a higher proportion of non-life sciences R&D.

R&D as a share of GDP performed by the government and the private non-profit sector remained broadly consistent in the UK between 2015 and 2021. More details of which organisations are included in these sectors for the UK can be found in the accompanying ‘life sciences competitiveness indicators 2024: user guide’ in the section on Research and Development.

Business Enterprise expenditure on R&D

Pharmaceuticals was the ONS product group which accounted for the largest share of total expenditure on R&D performed by UK businesses. The sector performed £9.0 billion of R&D in 2022, accounting for 18% of the total R&D expenditure. Expenditure on pharmaceutical R&D performed by UK businesses was equivalent to 0.36% of GDP in 2022.

Figure 4: Current expenditure on pharmaceutical R&D performed in UK businesses in 2022 by research type

Figure 4 above shows current expenditure on pharmaceutical R&D performed in UK businesses in 2022 by research type.

Notes:

  • Data from figure 4 can be found in table 5 of the accompanying ‘life sciences competitiveness indicators 2024: data tables.’
  • Only current R&D expenditure (not capital) is available split by research type
  • R&D types are defined by the OECD as follows:
    • Basic research: experimental or theoretical work undertaken primarily to acquire new knowledge of the underlying foundations of phenomena and observable facts, without any particular application or use in view.
    • Applied research: original investigation undertaken in order to acquire new knowledge that is directed primarily towards a specific, practical aim or objective.
    • Experimental development: systematic work, drawing on knowledge gained from research and practical experience and producing additional knowledge, which is directed to producing new products or processes or to improving existing products or processes.

Around two thirds of current expenditure on pharmaceuticals R&D performed by UK businesses was spent on experimental development R&D in 2022. This was the research type with the largest value of expenditure, followed by applied research (with 24% of the total pharmaceuticals R&D spend), and basic research (10%).

Figure 5: Source of funds for gross expenditure on pharmaceutical R&D performed by UK businesses in 2022

Figure 5 above shows source of funds for gross expenditure on pharmaceutical R&D performed by UK businesses in 2022.

Notes:

The majority (79%) of expenditure on pharmaceutical R&D performed by UK businesses in 2022 was funded by the businesses themselves. Overseas companies/investors were the source of funding for a further 19% of pharmaceutical R&D expenditure. The UK government funded just over 1% of pharmaceutical R&D performed by UK industry in 2022.

This data is only presented for the UK whilst a suitable data source is found to allow appropriate international comparisons.

Clinical trials

Data on the following metrics is extracted from the Centre for Medicines Research (CMR) Global Clinical Performances Metrics, Clarivate:

  • Percentage of patients recruited to a subset of commercial global studies (all trial phases)
  • Median time between clinical trial application to a regulatory authority and the first patient receiving a first dose for commercial trials (all trial phases)

This includes data from 25 pharmaceutical companies that participated in data collection activities. As a result, this metric only includes commercially sponsored trials. This data also only considers interventional trials, where a medicine is tested on participants, and trials for novel medicines (newly launched medicines or recently launched for a new indication). The data considers all phases of trials. More details are available in the accompanying ‘life sciences competitiveness indicators 2024: user guide’ in the section on clinical trials.

The UK and most European comparators’ share of patients recruited to commercial trials has fluctuated with the USA continuously accounting for a substantially higher share.

Figure 6: Percentage share of patients recruited to a subset of commercial global studies for novel medicines (all trial phases)

Figure 6 above shows percentage share of patients recruited to a subset of commercial global studies for novel medicines (all trial phases).

Notes:

In 2022 the UK’s share of patients for a subset of commercial clinical trials for novel medicines was 2.6% (8,689 out of 340,536 patients), a notable increase from 2021, when the UK accounted for a share of 2.2% of patients recruited. As a result, the UK’s ranking amongst comparator countries rose to fourth in 2022, up from fifth 2021.

The UK saw its highest share of patients recruited to these commercial trials in 2015, with 4.2% of patients, after which the UK’s share declined each year until 2018. Since 2018, the UK’s share has increased, except for a decline seen between 2020 and 2021. However, most other comparator countries also saw a decrease in their share of patient recruitment between 2020 and 2021, with the exception of the USA (whose share increased from 25.5% to 34.2%). Data for 2020 and 2021 will have been substantially influenced by the COVID-19 pandemic. During the pandemic many countries paused non-essential research and moved focus towards COVID-19 research, which was frequently non-commercially funded in the UK and other comparator countries. Only data on commercially funded trials are included in these international comparison statistics.

The USA has continuously had the highest share of patients since 2012 and saw notable increases in its share in both 2022 and 2023, following a period of decline between 2018 and 2020. The USA’s share of patients reached 43.6% in 2023, the highest seen since 2014 and 14 times higher than Germany in 2023, the country with the second highest share amongst comparators.

All other comparator countries’ patient shares have fluctuated markedly over the period, but all have continuously accounted for a substantially lower share of patients than the USA.

This metric only presents a subset of commercial trials to allow a standardised comparison between countries. For the UK this data relates to 128 clinical trials in 2022 - the number of studies included for other countries and for past years is available in the accompanying ‘life sciences competitiveness indicators 2024: data tables’.

Data in table 1 from the National Institute of Health Research’s (NIHR) Clinical Research Network (CRN) shows how many patients were recruited to a wider range of commercial interventional trials in the UK (3,181 trials in 2023/24).  This data is presented to give a picture of the UK’s wider clinical trial landscape only, as no internationally comparable data is available for other countries. The NIHR data does not include early phase trials in healthy volunteers.

Table 1: Number of interventional studies and number of patients recruited by commercial status in the UK.

Recruitment 2019/20 2020/21 2021/22 2022/23 2023/24
Number of patients recruited 201,821 166,780 467,851 342,390 349,019
Commercial studies 14,807 28,114 18,124 19,984 18,140
Non-commercial studies 187,014 138,666 449,727 322,406 330,879
Number of interventional studies 3,091 2,613 3,171 3,262 3,181
Commercial studies 1,291 1,091 1,393 1,449 1,467
Non-commercial studies 1,800 1,522 1,778 1,813 1,714

The majority of patients recruited to interventional trials in the UK are recruited to non-commercial studies, with only 5% of patients in 2023/24 recruited to commercial trials. This proportion has remained broadly consistent since 2021/22. Despite accounting for a minority of patient recruitment in the UK, commercial trials accounted for 46% of interventional trials, a percentage which has remained consistent since 2019/20.

DHSC also publishes monthly figures for recruitment to both non-commercial and commercial trials in their UK Clinical Research Delivery Key Performance Indicators Report. Please note these figures include both interventional and observational research so aren’t directly comparable to the above.

Median time from application to first dose to first patient in the UK remained consistent in 2022 compared to 2021 following an increasing trend since 2018.

Figure 7:  Median number of days from clinical trial application to a regulatory authority and the first patient receiving a first dose for a subset of commercial trials for novel medicines (all trial phases)

Figure 7 above shows median number of days from clinical trial application to a regulatory authority and the first patient receiving a first dose for a subset of commercial trials for novel medicines (all trial phases).

Notes:

  • The y-axis does not begin at 0.
  • Data from figure 7 can be found in table 7 of the accompanying ‘life sciences competitiveness indicators 2024: data tables.
  • Higher values equate to a longer time from application to first dose to first patient. Countries with lower values have a higher rank.

The time from clinical trial application to first patient first dose includes the time taken for:

  • Regulatory approval
  • Set-up including recruiting patients

In 2022, the median time in the UK between a clinical trial application being submitted to a regulator and the first dose to first patient was 273 days for a subset of commercial trials. This is broadly similar to the number of days in 2021, when the median time was 271 days. Prior to this, the median time for the UK increased each year between 2018 and 2021. The USA continues to have the shortest turnaround time in 2022 with 167 days, followed by Australia with 228 days.

The UK’s ranking against comparator was eighth in 2022, a rise from ninth in 2021. Whilst the UK saw similar median times in 2021 compared to 2022, several other countries saw notable increases such as Switzerland, Spain and Italy (with increases of 124, 26 and 44 days respectively).

The median times in 2020 and 2021 were likely impacted by the COVID-19 pandemic, when many countries pivoted research efforts to COVID-19 from other indications.

Every comparator country is now taking longer to approve and set-up clinical trials in 2022 compared to 2018 (when data collection begun). This ranges from an increase of 200 days in the median length of time between 2018 and 2022 in Switzerland compared to an increase of only 25 days in the USA.

For the UK this data relates to 124 clinical trials in 2022. The number of studies included for other countries and for past years is available in the accompanying ‘life sciences competitiveness indicators 2024: data tables’.

The above data refers to the period up to the end of 2022, but it should be noted that DHSC also publishes more timely data for the UK as part of their UK Clinical Research Delivery Key Performance Indicators Report. In April 2024, 71% of commercial contract studies and 81% of commercial collaborative studies were recruiting to time and target. Please note that this data for the UK isn’t directly comparable to the international comparison data due to the inclusion of both interventional and observational trials, but can be used as an indication for more recent trends.

For the UK, clinical trials need to be approved by both the Medicines and Healthcare products Regulatory Agency (MHRA) and the Research Ethics Service (RES) supported by the Health Research Authority (HRA). As of 2022, all trial applications in the UK are subject to combined review from MHRA and HRA. Before 2022, applications could be initially submitted to either body, with the timelines for approval not necessarily being sequential or through the combined review process. The starting point for the UK takes the date for which body the applicant submitted to first if the trial was not reviewed through combined review.

Table 2 provides timelines for clinical trial approval from MHRA and HRA in the UK, and indicates the extent to which the median turnaround time can be attributed to regulatory approval, as opposed to the set-up of a clinical trial, including recruitment of patients. Data in table 2 is not directly comparable to the metric used for making international comparisons above (time from first application to first patient receiving a first dose). This is because table 2 includes all commercial Clinical Trials of an Investigational Medicinal Product (CTIMP) whereas data extracted from CMR only includes a subset of commercial trials for novel medicines.

Figures in table 2 are also not directly comparable to the length of time from first clinical trial application to a regulatory authority to first patient receiving a first dose and cannot be used to derive how much time is taken for approval compared to clinical trial set up and recruitment in the UK.

Table 2: median number of days for commercial clinical trial approval in the UK by whether they were reviewed through combined review.

Year 2019 2020 2021 2022 2023
Standard CTIMPs not reviewed through combined review 108 92 90 n/a n/a
Standard CTIMPs reviewed through combined review 59 63 63 78 130

Table 3: number of commercial clinical trial applications reviewed through combined review.

Year 2019 2020 2021 2022 2023
Number of HRA Approval applications for CTIMPs that were reviewed through combined review 50 95 196 442 608

Notes:

  • From 2022 onwards, all trials are now reviewed through combined review.
  • For standard CTIMPs the timeline is from first regulatory application to last regulatory approval. For combined review there is one application and one approval.
  • HRA approval includes approval from Research Ethics Committees (REC) and Administration of Radioactive Substances Advisory Committee (ARSAC).

The figures in table 2 show that combined review resulted in shorter median approval times for interventional commercial trials in the UK between 2019 and 2022. Despite this, the median length of time to approve interventional trials through combined review has increased to 130 days in 2023, up from 78 days in 2022 for interventional trials. However, DHSC’s UK Clinical Research Delivery Key Performance Indicators Report show that 96% of trials in April 2024 received combined regulatory review within 60 days. This figure is not directly comparable to either the international estimates in this section or the UK data in table 2 due to the fact that this figure covers both commercial/non-commercial and observational/interventional trials, whilst other data throughout this report is restricted to interventional commercial trials to align with the availability in international data. Despite this, these figures give a timelier picture on regulatory timings and an indication of more recent performance.

All clinical trial data in this section refers to all trial phases combined. Further comparisons for the UK by trial phase are available through data reported by the Association of British Pharmaceutical Industry (ABPI) on their facts, figures and industry data on clinical trials.

Citations

Citations data tends to take about 3 years after the publication to stabilise, so it should be noted that citation data presented here for more recent years, particularly for 2023, should be interpreted with caution and may be retrospectively backdated in future editions of the LSCIs.

The UK’s share of medical science citations has declined since 2017 but has consistently ranked third.

Figure 8: Percentage share of global medical sciences academic citations

Figure 8 above shows percentage share of global medical sciences academic citations.

Notes:

This metric shows the share of global medical sciences academic citations held by the UK and its comparator countries (other G7 countries as well as Brazil, China, India, Russia, and Republic of Korea). Citation counts can be used to indicate the total citation impact of a country’s medical sciences publications.

In 2023, the UK’s share of global medical sciences academic citation counts was 11.5%, similar to 2022 but this share has seen a slight but steady decline since 2017. Despite this, the UK has consistently placed third amongst comparator countries since 2017, behind only the USA and China who accounted for a 31.6% and 24.0% of medical science citation counts respectively in 2023.

The UK’s ranking fell from second to third in 2017 due to China’s share markedly increasing. Whilst the USA has continuously accounted for the highest share of citations relative to comparators, there has been a declining trend in the USA’s share since 2011.

The UK’s publications have consistently had high proportion of publications that are highly cited compared to comparators.

Figure 9: proportion of medical science publications that are amongst the most cited (top 1%) globally

Figure 9 above shows proportion of medical science publications that are amongst the most cited (top 1%) globally.

Notes:

This metric indicates the proportion of each country’s publication which are among the most-cited globally within the field of medical sciences. This is calculated by taking the number of medical sciences publications for each country which are amongst the top 1% most cited globally as a proportion of that country’s total scholarly output (total publication count).

The share of global citation count indicates the volume of citations each country’s publications receive; this metric is a useful indication of how influential each country’s medical sciences publications are.

It should be noted that publications can be cited several years after their publication date, so data for more recent years will be incomplete and will continue to accumulate after publication of the LSCIs. Despite this, data from recent years are still presented as an early indication of how countries’ newer publications compare to others.

In 2023, 1.8% of the UK’s medical sciences publications were in the top 1% of the most-cited medical sciences publications globally. As a result, the UK had the highest proportion out of all comparator countries in 2023, similar to France, Italy and Germany, where 1.8%, 1.7% and 1.7% respectively of publications were in the top 1% of most cited publications.

The UK’s proportion of medical science publications that were highly cited has declined from 2.7% in 2020 but, as noted above, citations for more recent medical science publications will continue to accumulate in the years following this data snapshot. For this reason, the most recent years’ data for the UK and comparator countries may be revised in future, which may alter trends.

Patents

The UK’s count of life sciences patent applications per thousand population has been broadly consistent over time.

Figure 10: number of patent applications per thousand population

Figure 10 above shows number of patent applications per thousand population.

Notes:

This metric shows the number of life sciences patent applications (adjusted for population) made from each country in each year. Applications are assigned to the country in which the applicant (either a company, a university, or an individual) is registered or based.

Although this metric is generally a good proxy of where and when innovative life sciences activity took place, it is important to note that the applicant address may be the address of a company’s head office, or the inventor’s home address, rather than the actual location of where the invention took place. This means that, in some circumstances, patents may originate from research and development that took place in a different country to the ‘applicant country’.

It is also important to note that patent data (for the most recent years in particular) is subject to revisions. The most recent data can be revised substantially due to patent publication delays or retrospective changes by patent offices following discussion with applicants. The result of this is that data takes a few years to accumulate and ‘settle’, and that trends for recent years should be interpreted with caution.

The UK has seen a fairly similar number of life sciences patent applications per thousand population over time, with an average of 0.18 between 2011 and 2021. In 2021, the UK had 0.14 life sciences patent applications per thousand population. This figure is lower than the average yearly rate since 2011 but, as mentioned above, this figure is likely to be revised up in future as more data becomes available, and therefore may not be an accurate indication of a decline in UK life sciences patenting activity. This has resulted in the UK ranking fifth amongst competitors in 2021, a ranking which has been broadly stable since 2011 and fluctuating between fourth and fifth over this period.

Switzerland has consistently had the highest number of life sciences patent applications per thousand population amongst comparator countries, with between 3 to 5 times the number of patent applications per thousand population than the second highest comparator country for the entire period between 2011 and 2021. Switzerland’s count of patent applications per thousand population has been declining since 2013 - however, it’s worth noting that revisions to the most recent data may reveal that the decline is not as substantial as it appears to be currently.

By contrast, the USA has seen a more stable trend and has consistently ranked second behind Switzerland. Germany has seen a fairly consistent decline in the number of life sciences patent applications per thousand population since 2012. Despite this, it has continued to rank third amongst comparator countries for the entire period between 2012 and 2021.

When measuring patenting activity, the Relative Specialisation Index (RSI) value can show the volume of patents filed in a given country in a specific field relative to overall patenting levels in that country.

An RSI value greater than zero indicates that a country has a higher share of a particular technology relative to its overall share of patent families. In 2021, the UK’s RSI value for life sciences patents was -0.27, indicating that disproportionately few life sciences patents are filed in the UK compared to other fields. Most comparators similarly had a negative RSI value for life sciences, but countries such as Canada and Brazil had a positive RSI of 0.44 and 0.43 respectively in 2021, meaning more life sciences patents are filed there compared to other fields. The methodology for the RSI has changed since the publication of the LSCI 2022 report. More details on this change can be found in the accompanying ‘life sciences competitiveness indicators 2024: user guide‘. The time series in this report has been backdated with the new methodology.

Section 2: Domestic market

Access to pharmaceuticals

This report takes the analysis from the European Federation of Pharmaceutical Industries and Associations’ European Federation of Pharmaceutical Industries and Associations (EFPIA) W.A.I.T Indicators. The analysis is based on new medicines that received central marketing authorisation from the European Medicines Agency (EMA) within the associated time periods.

A medicine being available in this analysis in England and Scotland is defined as when the National Institute of Health and Care Excellence (NICE) and the Scottish Medicine Consortium (SMC), respectively, have issued a positive recommendation as part of their technology appraisal processes. If the medicine was not evaluated by NICE or SMC, IQVIA sales data was analysed to determine if the medicine is available. Of the constituent countries of the United Kingdom, only England and Scotland are included in these figures due to data availability. The definition for other countries can be found in the ‘Appendix and detailed methodology’ in the EFPIA W.A.I.T indicators.

The time to availability takes the median length of time from marketing authorisation received by the relevant medicines regulator to when a medicine is considered ‘available’ to patients. For data relating to the period ‘2019 – 2022’:

  • for England and Scotland, the Medicines and Healthcare products Regulatory Agency (MHRA) marketing authorisation date is used for medicines that received marketing authorisation in 2021 or 2022. For medicines that received marketing authorisation in 2019 or 2020, the date of central marketing authorisation from the European Medicines Agency (EMA) is used.
  • for other countries, either the date of marketing authorisation from the European Medicines Authority (EMA) for EU countries or the relevant regulatory body in non-EU countries is used for all years.

For data relating to the periods 2018 to 2021 and before, all data for England and Scotland used the starting date of central marketing authorisation from the EMA. Following the UK’s exit from the EU, from 2021 onwards, the MHRA are the sole regulator to approve medicines for marketing authorisation in the UK. Data cohorts prior to 2019 to 2022 have not been backdated with this change so comparisons to past years should be made with caution.

The ‘date of availability’ for England and Scotland is defined as:

  • England: For medicines with a positive NICE recommendation, the accessibility date is the date of published final draft guidance (cancer medicines) or date of published guidance + 90 days (non-cancer medicines). Cancer medicines benefit from earlier funding. For the remaining medicines, the IQVIA sales data is analysed to determine month of routine availability.
  • Scotland: For medicines with a positive SMC recommendation, the accessibility date is the date of published final guidance. For remaining medicines, IQVIA sales data is analysed to determine month of routine availability.

For information on previous changes to this definition and what is used for other countries, please see the ‘Access’ section of the ‘life sciences competitiveness indicators 2024: user guide’ and the EFPIA W.A.I.T indicators publication.

The rate of availability for new medicines has been declining in most European comparators.

Figure 11: Percentage of new medicines receiving central marketing authorisation between 2015 and 2022 that are available to patients

Figure 11 above shows percentage of new medicines receiving central marketing authorisation between 2015 and 2022 that are available to patients.

Notes:

There were 167 new medicines in the analysis that received central marketing authorisation from the European Medicines Agency (EMA) between 2019 and 2022; 56% of these medicines were made available to patients in England and 54% were made available in Scotland. This proportion has declined compared to the past period for both nations, with England seeing a continuous decline over the previous 3 periods from 72% in the period 2016 to 2019. Scotland had previously seen 2 periods of increases leading to a peak of 63% in 2018 to 2021 before falling to 54% in the latest period.

England ranked seventh out of 13 comparators in the period 2019 to 2022, a decrease from sixth in the previous 2 periods and from fifth in the period 2016 to 2019. Scotland ranked ninth out of 13 comparators in the period 2019 to 2022, a position which has fluctuated slightly and declined from seventh in the previous period. Most other comparators saw a similar declining trend since 2017 to 2020 resulting in broad stability within the rankings. The exception to this trend was Spain, where substantial increases in the percentage of medicines made available were seen in recent periods, rising from 53% to 62% in the periods 2017 to 2020 and 2019 to 2022 respectively.

Across European comparators, there is high variation in the proportion of medicines made available, with 88% of medicines available in Germany compared to only 28% in Ireland (note this analysis uses 13 comparator countries but only the top 10 for the period 2019 to 2022 are visualised in the charts) in the period 2019 to 2022.

More information on the differences between how medicines are reimbursed across Europe can be found in the World Health Organisation’s (WHO) report on Medicines reimbursement policy in Europe.

Time to availability for new medicines varies substantially across Europe with both England and Scotland placing around the centre of the rankings against comparator countries.

Figure 12: Median number of days between marketing authorisation and medicines being made available for medicines that received central marketing authorisation between 2019 and 2022

Figure 12 above shows median number of days between marketing authorisation and medicines being made available for medicines that received central marketing authorisation between 2019 and 2022.

Notes:

  • A higher median number of days indicates new medicines take longer to be available to patients in the respective country.
  • The marketing authorisation (MA) date is based on the EMA central marketing authorisation date for all countries except England, Scotland and Switzerland, where local authorisation dates are used instead.
  • Data from figure 12 can be found in table 12 of the accompanying ‘life sciences competitiveness indicators 2024: data tables‘.

For medicines that received marketing authorisation between 2019 and 2022, the median time from the marketing authorisation date to availability, referred to as the time to availability, was 299 days in England. The median time has remained broadly consistent over all 5 time periods for which data is available, although England saw a slight increase in rank to fifth in 2019 to 2022 from sixth in 2018 to 2021.

For Scotland, the median time to availability for medicines approved between 2019 and 2022 was 313 days. This has declined substantially over the past 2 periods from 384 days in the period 2017 to 2020. Due to this change, Scotland’s ranking has increased over the same period to sixth in 2019 to 2022 from ninth in 2017 to 2020.

The aforementioned change to marketing authorisation dates for England and Scotland affects the data relating to the 2019 to 2022 period only. For medicines that received marketing authorisation in 2021 or 2022, the time to availability is measured by calculating the time between the MHRA marketing authorisation date and the NICE publication of appraisal date (90 days are added for England for non-oncology medicines as described above). For medicines included in the 2019 to 2022 period which received marketing authorisation in 2019 or 2020, and for all medicines in all previous periods, the central marketing authorisation dates from the EMA were used.

Prior to 2021, some medicines in the UK’s data would have been approved using the central European process, which is why the EMA date has been used historically for the UK in this analysis. From 2021 onwards the MHRA became the sole regulatory body for medicines in the UK, hence the change in methodology. However, please note that the changes to the marketing authorisation dates only applied to the latest period and have not been backdated for the entire time series, meaning that the time to availability for the medicines receiving marketing authorisation in 2021 in the 2018 to 2021 period continues to be measured from the EMA date. The average length of time to approval in England and Scotland from central European marketing authorisation for the period 2019 to 2022 can be found in the published W.A.I.T indicators.

Similarly to the proportion of medicines made available, there is high variation in the median time to availability, with a median time of 47 days in Germany in the period 2019 to 2022 compared to 613 in Spain over the same period (note this analysis uses 13 comparator countries but only the top 10 are visualised in the charts). Countries vary in what processes they use to carry out health technology assessments and approve medicines for usage in different populations. More details on the definition for the length of time for medicines to become available can be found in the accompanying ‘life sciences competitiveness indicators 2024: user guide‘.

The Cancer Drugs Fund (CDF) was introduced in 2011 (and reformed in 2016) in England to provide earlier access to patients for innovative treatments. In 2022, the Innovative Medicines Fund was launched to provide a similar early access option for non-cancer medicines.

Uptake of medicines

The uptake ratio measures the relative adoption of new medicines in the UK in contrast to other countries. The uptake ratio is a measure of relative uptake in terms of days of therapy (DOT) per capita for new medicines recommended by NICE and first launched between 2016 and 2022. A ratio of the UK DOT per capita to the average DOT per capita for comparator countries is calculated for each medicine, and then the median of these ratios is taken to summarise how uptake in the UK compares to other countries – this value is hereafter referred to as the uptake ratio.

An uptake ratio of 1 means the median UK per capita consumption (referred to in this report as ‘uptake’) is equivalent to the average uptake per capita in the comparator countries.

An uptake ratio of less than 1 means the median UK per capita consumption is lower than the average uptake per capita in the comparator countries. Conversely, an uptake ratio of greater than 1 means the median UK per capita consumption is greater than the average uptake per capita in the comparator countries.

The uptake ratio accounts for individual country population size, but not for need -number of cases and Health Technology Assessment (HTA) authorities’ recommended coverage) - standard clinical practice or total medicine spend in each country. It also does not adjust for the impact of different marketing or launch strategies in different countries. These factors are likely to have a substantial impact on uptake figures.

In many cases there is no consensus as to what the ideal level of uptake should be. As such, high or low usage should not be interpreted as good or bad performance in itself. Nonetheless, the uptake ratio with respect to an international benchmark may be used to understand how UK adoption of new medicines changes in the years following their introduction.

Uptake in the UK continues to be below the average of comparators.

Figure 13: UK uptake (days of therapy) of new medicines, per capita, as a ratio of comparator countries average

Figure 13 above shows UK uptake (days of therapy) of new medicines, per capita, as a ratio of comparator countries average.

Notes:

  • The figures only include medicines with a positive NICE recommendation.
  • Each line refers to the cohort of medicines with a launch date in the labelled years. The x-axis refers to the number of years after launch for each medicine in the cohort. -The figures are adjusted for population size between countries but not for other factors (such as disease prevalence and HTA authorities’ recommended coverage) which may influence differences in uptake.
  • Data from figure 13 can be found in table 13 of the accompanying ‘life sciences competitiveness indicators 2024: data tables‘.

The comparator countries used to derive the uptake ratio are Australia, Austria, Belgium, Canada, Finland, France, Germany, Ireland, Italy, Japan, Netherlands, Spain, Switzerland, Sweden, USA.

For medicines launched between 2018 and 2022, the uptake ratio one year after launch was 0.52, meaning that the average uptake of new medicines per capita in the UK was around half of the comparator country average. This ratio has not increased compared to the previous 2 periods, when this ratio was 0.52 for medicines launched in the 2017-2021 cohort, and 0.61 for medicines launched between 2016-2020.

For these medicines launched between 2018 and 2022, there is a yearly fluctuation of the uptake ratio from 1 year after launch through to 5 years after launch. The uptake ratio increases to 0.62 2 years after launch, and reaches a peak of 0.72 in year 4. By 5 years after launch the uptake ratio has decreased to 0.62, the same ratio experienced 2 years after launch. This figure should be interpreted with caution since only 5 medicines are used in the calculation, because very few medicines receiving HTA approval between 2018 and 2022 have had sufficient time to accumulate a full 5 years of data. Table 4 shows the uptake ratio values alongside the number of medicines in the calculations for each period.

For the previous 2 cohorts, the uptake ratio 5 years after launch was 0.63 for medicines launched between 2016-2020 and 2017-2021. For these cohorts, more medicines have accumulated 5 years of uptake data since launch (13 for 2017 to 2021 and 21 for 2016 to 2020) but this is still a substantially lower number of medicines compared to analysis for uptake one to 4 years after launch.

A median value for uptake is taken across all medicines for each country, to show broadly how UK uptake compares to other countries. It should be noted however that there is substantial variation between medicines for the average uptake in the UK compared to other countries. Each medicine is weighted equally in the analysis but the eligible patient population varies substantially for different medicines and between different countries.

Table 4: Uptake ratios for the UK and number of medicines included in the ratio calculation

Measure Launch year Year 1 Year 2 Year 3 Year 4 Year 5
Uptake ratio 2016-20 0.61 0.65 0.70 0.70 0.63
Uptake ratio 2017-21 0.52 0.65 0.70 0.70 0.63
Uptake ratio 2018-22 0.52 0.62 0.70 0.72 0.62
Number of medicines in the analysis 2016-20 77 73 53 35 21
Number of medicines in the analysis 2017-21 83 78 45 27 13
Number of medicines in the analysis 2018-22 75 62 36 18 5

This report does not rank countries by their uptake of medicines due to the uncertainty around the ideal level of uptake for each individual medicine. This measure does not make inferences on what the UK’s ratio should ideally be but exists to provide information on how the UK is utilising new medicines compared to peers and how that is changing over time.

Availability and utilisation of diagnostic technologies

The UK continues to have lowest number of MRI units, CT and PET scanners per million population amongst comparator countries.

Figure 14: Number of MRI units, CT and PET scanners per million population

Figure 14 above shows Number of MRI units, CT and PET scanners per million population.

Notes:

  • Data from figure 14 can be found in table 14 of the accompanying ‘life sciences competitiveness indicators 2024: data tables‘.
  • The chart visualises the 10 comparator countries with the highest number of scanners for the most recent year of data in addition to the UK, which has the lowest number of scanners out of 16 comparators.
  • For Australia this only includes equipment eligible for public reimbursement.
  • For Sweden scanners outside hospitals are excluded.
  • For Switzerland scanners outside of hospitals are excluded for CT and PET scanners.
  • For the UK, scanners outside of hospitals are excluded for data relating to 2019 and onwards.

This metric gives an indication of the differing levels of availability in the UK and comparator countries for 3 diagnostic technologies: computed tomography (CT), magnetic resonance imaging (MRI) and positron emission tomography (PET).

Whilst these technologies have an important function in medical diagnosis, it is important to note that there is no general international benchmark for the ideal number of CT scanners, MRI units or PET scanners.

The UK’s count of diagnostic technologies per million population have been presented alongside data for 15 comparator countries (the same 15 as used in the ‘uptake of medicines’ metric, see the section on uptake).

No new data is available for the UK since the publication of the 2023 LSCIs report. The most recent data available for the UK refers to 2021.

For the combined number of CT scanners, MRI units and PET scanners in 2021, the UK had the lowest number per million population, at 19.1, compared to all comparators. The UK has however seen an increase from 17.2 scanners per million population in 2020, an increase of 11% which is the largest relative increase seen out of all comparator countries with available data in 2020 and 2021.

The UK has also seen an overall upward trend between 2010 and 2020, although data for 2019 and after is not comparable to earlier data points as scanners outside of hospitals are excluded. PET scans are also not included in the total for data relating to 2010 to 2014 but these make up a small proportion of the total of scanners (3% in 2021).  Japan has a substantially higher combined number relative to all comparators at 177.8 per million population as of 2020, an increase of 4% since 2017.

Amongst comparator countries, Japan had by far the highest number of CT scanners and MRI units per million population in 2020 (115.7 and 57.4 per million population respectively). Meanwhile for PET scanners the USA ranked first with 5.8 per million population in 2020.

The UK had the lowest number of CT scanners (10.0), MRI units (8.6), and PET scanners (0.5) per million population in 2021 amongst comparator countries. Despite this, the UK has seen an increase of 12%, 10% and 25% in the number per million population for CT scanners, MRI units and PET scanners, respectively, compared to 2020.

Data for the UK only includes diagnostic equipment and scans performed in hospitals. As a result, the figures for the UK should be interpreted with caution against other countries as equipment in community settings will not necessarily be captured in these statistics.

The UK performed a comparatively low number of diagnostic exams to comparators with most countries seeing a decline in 2020 due to COVID-19.

Figure 15: number of diagnostic exams per 1,000 population

Figure 15 above shows number of diagnostic exams per 1,000 population.

Notes:

  • Data from figure 15 can be found in table 15 of the accompanying ‘life sciences competitiveness indicators 2024: data tables‘.
  • For Switzerland and the UK exams conducted outside of hospitals are not included.
  • For Australia exams conducted on public patients are not included.
  • For the Netherlands privately funded exams are not included.

This metric demonstrates the varying levels of diagnostic technology utilisation in the UK and comparator countries. Please note that the latest data for this metric relates to 2020 and 2021 in most countries, during the COVID-19 pandemic when many countries paused non-essential procedures including diagnostic exams. As such, data report for the years 2020 and 2021 is not comparable to previous time periods and should be used with caution. Rankings have not been presented for this year due to the varying impact COVID-19 would have had on each country’s diagnostic exams.

The UK’s count of diagnostic exams per 1,000 population is presented alongside that of 12 comparator countries – this is a subset of the 15 countries used for the international comparison of diagnostic technology equipment availability, as data for Japan, Sweden and Ireland was not available. Updated rankings are not used in this year’s report due to the lack of comparable data to past years due to the COVID-19 pandemic.

No new data is available for the UK since the publication of the 2023 LSCIs report. The most recent data available for the UK refers to 2020. Data for 2021 is available for other countries and most of these countries have seen a substantial increase in exams compared to 2020. This is likely due to non-essential exams being reintroduced around this time, but each country will have done this over a different time frame.

The UK performed 148.4 CT, MRI and PET exams combined per 1,000 population in 2020, a substantial decline of 15% compared to 2019. The decline in the UK will have been influenced by the pausing of non-essential exams during the pandemic. Several comparator countries saw a decline over the same time period, including the USA which previously performed the highest number of exams in 2019 by a substantial margin. Prior to 2020, the number of exams performed in the UK had seen an upward trend since 2012 with a year-on-year increase up until 2019 with 62% more exams performed in 2019 compared to 2012.

In 2020, 64% of the exams performed in the UK were CT scans, 34% were MRI scans and 2% were PET scans. CT scans similarly make up the largest share of diagnostic exams for all comparator countries, followed by MRI exams and then PET exams.

Section 3: Production environment

OECD data on economic activity has been used to replace Eurostat as the data source for the pharmaceutical manufacturing employment metric. This change has been made due to the fact that the UK is no longer included in the Eurostat data collection process, meaning that this data source is no longer appropriate for the purposes of comparing the UK to its comparator countries. The new OECD data source does not report on data at a sufficient level of granularity to be able to extract data on medical technology manufacturing employment, which means that the medical technology metric is not available for this publication. OLS will continue to look for other suitable sources for internationally comparable data on medical technology employment.

The selection of comparator countries has remained the same as in previous publications despite the change in data source.

Manufacturing employment

UK employment in pharmaceutical manufacturing has been stable since 2017.

Figure 16: Number of people employed in manufacture of basic pharmaceutical products and pharmaceutical preparations

Figure 16 above shows number of people employed in manufacture of basic pharmaceutical products and pharmaceutical preparations.

Notes:

In 2022, UK pharmaceutical manufacturing employment was 48,100, placing the UK sixth amongst comparator countries. The UK’s ranking has fluctuated over the years, reaching as high as third in 2012 and 2017. However, it should be noted that the UK’s employment levels have been similar to that of its nearest comparators (Spain, France and Switzerland) since 2017. The UK’s pharmaceutical manufacturing employment has been fairly steady since 2017, when employment was 48,500. Prior to 2017, pharmaceutical employment in the UK experienced a declining trend between 2013 and 2016, with employment falling from 48,700 in 2013 (the highest employment figure for the UK across the whole time period 2008-2022) to 39,300 in 2016.

Germany has consistently had the highest pharmaceutical manufacturing employment since 2008, with its employment figure in 2021 (the latest year available for the country) being over double that of any other comparator country.

Italy has ranked second amongst comparator countries in terms of pharmaceutical manufacturing employment every year since 2008, with a total of 66,600 employees in 2022. Ireland’s pharmaceutical manufacturing employment has seen substantial growth in recent years, with employment increasing 44% from 41,200 in 2018 to 59,500 in 2021. These increases meant that Ireland’s ranking amongst comparator countries changed from sixth to third over the same time period.

Figures presented only include employment in enterprises whose economic activity is classed as “manufacture of basic pharmaceuticals and pharmaceutical products”. Please note that some employment in pharmaceutical manufacturing may be captured within enterprises whose economic activity is classed under other categories (and therefore omitted from this data). The OLS uses a more comprehensive definition of the pharmaceutical sector within its definition of life sciences. Domestic figures for employment in the pharmaceutical sector are presented within the ‘bioscience and health technology sector statistics’ data. The data used in the LSCIs uses a narrow definition, as above, to allow an internationally standardised comparison to other countries. Please see the accompanying ‘life sciences competitiveness indicators 2024: user guide‘ for more details.

GVA for pharmaceutical manufacturing

The UK’s pharmaceutical manufacturing GVA has followed a slight upward trend between 2017 and 2021.

Figure 17: GVA for pharmaceutical manufacturing in 2022 (or latest year), chain linked volumes, base year 2015 (£ million)

Figure 17 above shows GVA for pharmaceutical manufacturing in 2022 (or latest year), chain linked volumes, base year 2015 (£ million).

Notes:

  • Data from figure 17 can be found in table 17 of the accompanying ‘life sciences competitiveness indicators 2024: data tables’.
  • 2022 data is unavailable for the UK, Germany and Spain.
  • USA data for this metric is not currently available so this country has not been included as a comparator country.

GVA measures the contribution to the economy that an industry makes. GVA is calculated as either the value of outputs from production minus the value of the inputs used, or revenue from pharmaceuticals minus the costs of production. All values in this section are in chained volume measures and rebased to 2015 prices.

The UK’s GVA for manufacturing has been increasing since 2017 from a value of £10.3 billion to £13.7 billion in 2021. This trend in similar for other comparator countries during this period, except for Finland, which experienced a decrease between 2017 and 2021, from £1.3 billion to £1.1 billion

Data for the USA is not currently available due to methodological changes in the data they submit to OECD. The USA had previously been a comparator country in past LSCIs publications and had the highest GVA of all comparators by a substantial margin. Due to the unavailability of data for the USA, rankings have been avoided for the 2024 LSCIs publication. However, it is expected that the USA will restart submitting data to OECD in due course and will be reflected in subsequent LSCIs publications, where possible.

The UK experienced the largest increase in GVA between 2019 and 2020, with a 20% increase. The increase in GVA seen in 2020 to 2021 for the UK was likely influenced by the COVID-19 pandemic when there was an increase in life sciences activity due to the efforts to develop treatments and vaccines for COVID-19.

Section 4: International collaboration

Export and imports of pharmaceuticals and medical technology products

The value of the UK’s exports of pharmaceutical products has increased since 2021 but remains lower than the peak seen in 2017.

Figure 18: value (£ billions) of global exports of pharmaceutical products

Figure 18 above shows value (£ billions) of global exports of pharmaceutical products.

Notes:

In 2023, the value of UK exports of pharmaceutical products was £25.6 billion, placing the UK tenth amongst comparator countries. The UK saw its highest value in 2017, at £27.6 billion, and subsequently saw a declining trend until 2021, with the value dropping by 19% over this period. In 2022 exports recovered to £25.8 billion, a 16% increase from 2021, and then saw a modest decrease of 1% between 2022 and 2023.

In contrast to the UK, several comparator countries saw high growth over the period 2013 to 2023. Germany and Switzerland were consistently the top 2 comparators for the entire period, with both countries seeing substantial overall growth over time. The USA and Ireland also saw notable growth, with Ireland having a similar value of exports to the UK in 2013, but nearly 3 times the value of the UK’s exports by 2023.

Whilst the UK saw a slight decline of 1% in the value of pharmaceutical exports between 2022 and 2023, there was variation in the trends seen in other countries. Countries such as the USA and the Netherlands saw notable growth between 2022 and 2023, whilst Belgium, China and Germany saw substantial decreases, to a larger extent than the UK.

The UK’s value of medical technology exports has been broadly consistent since 2019.

Figure 19: value (£ billions) of global exports of medical technology products

Figure 19 above shows value (£ billions) of global exports of medical technology products

Notes:

The value of UK exports of medical technology products in 2023 was £10.1 billion, an increase of £0.5 billion (5%) since 2022. UK medical technology exports increased between 2013 and 2019 from £7.5 billion to £10.1 billion, an increase of 34%, and the value of these exports has been broadly consistent since then with the exception of a slight decrease in 2022.

In 2023, the UK ranked eleventh amongst comparator countries in terms of the value of medical technology exports. The USA, China and Germany have consistently been the top 3 comparator countries since 2013, with the value of the USA’s medical technology exports in 2023 (£68.0 billion) being over 6 times that of the UK for the same year. There was a large spike in China’s medical technology exports in 2020, with the value of these exports rising to £92.4 billion, which was more than double the value of £38.8 billion seen in 2019. A sharp decline between 2020 and 2021 was followed by a second, smaller spike in 2022.

The commodities within ‘medical technology’ in this analysis include PPE products and ventilation equipment, which saw higher global demand during the pandemic. It is therefore likely that figures presented in this section of the report were impacted by the pandemic.

The value of UK imports of pharmaceutical products has decreased in 2023, following a notable spike seen in 2022.

Figure 20: value (£ billions) of global imports of pharmaceutical products

Figure 20 above shows value (£ billions) of global imports of pharmaceutical products.

Notes:

In 2023, the value of UK imports of pharmaceutical products was £24.9 billion, placing the UK tenth amongst the selection of comparator countries. The value in 2023 was a decrease of £5.5 billion, or 18%, from £30.4 billion seen in 2022.  The UK experienced the highest value of exports in 2022 over the period 2013 to 2023. Prior to this, exports had been increasing year-on-year from 2013 to 2017 which was then followed by a declining trend between 2017 and 2021.

The USA and Germany have consistently been the highest ranked comparator countries in terms of pharmaceutical imports for the entire period between 2013 and 2023. Similarly to the UK, Germany and Japan also experienced decreases between 2022 and 2023, with Germany’s pharmaceutical imports value falling by £7.7 billion (10%) and Japan’s falling by £7.9 billion (20%). By contrast, other comparators such as the USA and China saw notable increases over the same period. The USA and China saw increases of £10.5 billion (6%) and £7.4 billion (17%) respectively between 2022 and 2023.

The UK had a pharmaceutical products trade surplus of £0.8 billion in 2023 (meaning that UK exports exceeded UK imports by £0.8 billion) - this was the first year in which the UK had a trade surplus since 2015.

The value of UK imports of medical technology products continues to decrease slightly following a peak in 2020.

Figure 21: value (£ billions) of global imports of medical technology products

Figure 21 above shows value (£ billions) of global imports of medical technology products.

Notes:

The value of UK imports of medical technology products in 2023 was £15.5 billion, placing the UK sixth amongst comparator countries. The UK’s ranking against comparators has remained broadly consistent over the period 2013 to 2023, fluctuating between sixth and seventh.

UK medical technology imports increased gradually between 2013 and 2019, after which the value of imports increased substantially to £20.7 billion in 2020, an increase of 62% compared to 2019. Since then, imports have decreased each year up to 2023, with the most substantial of these decreases occurring between 2020 and 2021. Like the UK, several other countries also saw a large spike in 2020, such as Germany, France and Italy.

Despite experiencing a decline of £4.8 billion, or 5%, between 2022 and 2023, the USA’s value of medical technology exports continues to be more than double that of any other comparator country, at £85.3 billion in 2023.

In 2023, the UK had a trade deficit in medical technology products of £5.4 billion (meaning that the value of imports exceeded the value of exports by £5.4 billion). The UK has experienced a trade deficit each year between 2013 and 2023, with the widest deficit (£10.6 billion) seen in 2020. Since 2020, the trade deficit in medical technology products has narrowed each year.

Section 5: Investment environment

Foreign direct investment (FDI)

Foreign direct investment (FDI) is an investment from a foreign investor into an enterprise in a different country. The entity then becomes an affiliate enterprise, which is either a subsidiary, branch, or an affiliate company of the parent company – the foreign investor. In practical terms, a foreign company can either set up a version of itself in the country or can acquire/merge with an existing company.

The FDI data in this report however only includes situations where a foreign company has set up a new entity in the UK and doesn’t include mergers or acquisitions. The data also only includes publicly available data on FDI projects and therefore underestimates global FDI. More information can be found in the accompanying ‘life sciences competitiveness indicators 2024: user guide’.

This indicator is based on fDi Markets data available at the industry Cluster level definition for “life sciences”, which includes projects in pharmaceuticals, biotechnology, medical devices as well as some projects in adjacent sectors such as healthcare, software and IT, business services and various other industries where fDi Markets has tagged these projects as life sciences.

The UK’s ranking in FDI investment has fluctuated since 2012 but notable decreases have been seen since 2021.

Figure 22: life sciences inward foreign direct investment – estimated capital expenditure (£ millions)

Figure 22 above shows life sciences inward foreign direct investment – estimated capital expenditure (£ millions).

Notes:

Data on the value and number of FDI projects is sourced from fDi markets. An estimate is produced by fDi markets for any projects which do not have a known value for capital expenditure.

In 2023 the value of estimated inward FDI into the UK was £0.8 billion, which was a reduction of £0.2 billion, or 21%, compared to 2022. Despite this, the UK’s ranking slightly increased from ninth to eighth between 2022 and 2023, with several comparator countries also seeing notable declines in inward investment over the same period, such as Ireland, Belgium and the USA. This marks a second year of decline since 2021 for the UK, although most countries have seen notable declines in FDI over the same period due to a surge in investment to accelerate research into COVID-19 during the pandemic between 2020 and 2022.

FDI data is highly volatile year-on-year and can be heavily influenced by a small number of high value investments.

Despite a 16% decrease in inward FDI in 2023 compared to 2022, the USA remains at the top of the rankings with a value of £3.63  billion in 2023. Germany closely follows ranked second with an inward FDI of £3.60 billion in 2023, but by contrast has seen a substantial increase since 2022, with FDI reaching 3 times its value of £1.0 billion in 2022.

The value of estimated inward FDI in 2023 was generated from 60 projects in the UK, which was slightly higher than the previous 2 years when there were 47 projects in 2022 and 49 projects in 2021. Whilst the number of projects increased in 2023, the amount of investment declined, meaning a lower average expenditure per project. The USA had the highest number of projects in 2023 at 144, whilst India and Germany both also ranked higher than the UK with 71 and 63 projects respectively. However, it should be noted that the count of inward FDI projects is highly volatile year-on-year.

This data uses the fDi markets definition of ‘life sciences’ and as a result some projects included do not necessarily align with the definition of life sciences considered in the Office for Life Sciences official statistics on bioscience and Health Technology Sector Statistics (BaHTSS). Despite this, the fDi data provides a consistent definition across countries to allow for international comparisons.

Equity finance raised by industry

Industry investment in this report refers to the amount of equity capital raised by the issuing of new shares by life sciences companies. The values presented in this section represent equity raises by private and publicly listed companies that have been publicly disclosed (please note that private companies do not always disclose capital raises, and therefore the data may be incomplete). One type of equity financing is initial public offerings (IPO) which are also reported on in the next section of the report.

The data for both equity finance and IPOs in this report includes companies listing for the first time on a stock exchange, as well as companies relisting on a different stock exchange to their initial listing. The relisting value will also be included in the figures in this section. More details can be found in the accompanying life sciences competitiveness indicators 2024: user guide’.

Equity finance raised in 2023 dropped in most countries compared to 2022.

Figure 23: equity finance raised by life sciences companies, (£ millions, currency translations at historic exchange rates)

Figure 23 above shows equity finance raised by life sciences companies, (£ millions, currency translations at historic exchange rates).

Notes:

Equity finance raised by the UK life sciences industry fell to £2.9 billion in 2023, down from £3.4 billion in 2022, a decrease of 14%. This marks the second year-on-year decline since 2021. Similarly, substantial decreases were seen in many countries globally due to high investment in life sciences companies during the COVID-19 pandemic in 2020 and 2021.

Despite the decrease seen in equity finance raised in the UK, its ranking relative to other comparators rose to third in 2023, up from fourth in 2022. While the USA and China experienced a decline of 4% and 47% respectively from 2022, they still raised substantially more equity finance against comparators with £52.6 billion and £12.4 billion raised respectively.

The decline seen in 2023 has meant that the value of equity finance raised by the UK life sciences industry has returned to a similar level to that seen in 2017.

IPOs

An IPO describes the act of a company offering their stock on a public stock exchange for the first time. An IPO allows a company to raise capital from public-market investors and enables its shares to be traded after the listing. A publicly listed company is more likely to increase its activities in the country where it is listed.

The data in this report includes companies that have previously listed on one country’s stock exchange and then relisted on another country’s. Both the initial offering and the relisting are included in these figures if in the referenced time series.

The value raised in IPOs in the UK and most comparators has substantially fallen between 2021 and 2023.

Figure 24: Amount raised (where known) in life sciences initial public offerings (IPOs) (£ million, currency translations at historic exchange rates)

Figure 24 above shows amount raised (where known) in life sciences initial public offerings (IPOs) (£ million, currency translations at historic exchange rates).

Notes:

  • Data from figure 24 can be found in table 26 of the accompanying ‘life sciences competitiveness indicators 2024: data tables’.
  • The value of an IPO is determined by the amount of money it raises, which generally reflects the valuation of the company, and its growth prospects. IPOs are also one type of equity finance so the values for IPOs are included in the equity finance figures in this report.

In 2023, the UK had no IPOs in life sciences, a decrease from the £7.1 million raised from 3 IPOs in 2022, and the £726.9 million over 11 IPOs raised in 2021. As with equity finance overall, this trend has been seen in other countries globally due to the spike in investment seen in life sciences companies around 2020 and 2021 during the COVID-19 pandemic.

Both the number of IPOs and amount raised has been highly volatile year to year, but 2023 was the first time since 2012 that the UK had no IPOs in life sciences. China, the USA and Hong Kong have consistently been the top 3 countries in terms of amount raised in IPOs since 2017 although the value raised in each country fluctuated substantially year-on-year. China saw the highest absolute decrease between 2022 and 2023, with the value raised from life sciences IPOs falling to £2.2 billion from £7.4 billion in 2022 (a fall of 71%). This decrease was not large enough for China to cease to be the highest-ranking comparator country in 2023, although it did substantially close the gap between China and the USA (who raised £1.7 billion in 2023). India saw the largest absolute and relative increase in the amount raised from life sciences IPOs, with £95 million raised across 6 IPOs in 2022 and £739m raised across 12 IPOs in 2023 - a more than sevenfold increase in terms of value raised.

China, the USA, Hong Kong and India accounted for 76% of the IPOs across all comparator countries in 2023 and 96% of the amount raised.

Section 6: Access to skilled labour

The UK continued to rank second but saw a substantial decline in 2020 compared to 2019 for the proportion of graduates from life sciences fields.

Figure 25: Percentage of graduates from tertiary education graduating from natural sciences, mathematics, and statistics programmes, both sexes (%)

Figure 25 above shows percentage of graduates from tertiary education graduating from natural sciences, mathematics, and statistics programmes, both sexes (%).

Notes:

Tertiary education comprises undergraduate degrees (or equivalent) and above - this metric shows the percentage of graduates from tertiary education graduating from natural sciences, mathematics and statistics programmes.

The UK has a high proportion of graduates completing degrees in natural sciences, mathematics and statistics relative to comparators, ranking second behind India in 2021. Whilst the UK has a high percentage compared to other countries, there was a steep decline in the percentage of graduates completing these programmes between 2019 and 2021. In 2021, 8.7% of graduates completed degrees in these fields compared to 13.4% in 2019.

In addition to the number of graduates, the number of life sciences apprenticeships started each year in the UK can be a measure of the sector’s skills base. In the financial year 2022/23, the number of life sciences apprenticeships started was 1,240, a decrease of 9% compared to the previous financial year. The number of starts had previously been consistent between 2018/19 and 2020/21, followed by a spike seen in 2021/22 of 25% compared to the previous year. Whilst starts in 2022/23 had seen a decline compared to the high in 2021/22, the number of starts remained higher than the period between 2018/19 and 2020/21.

Three hundred and fifty of the life sciences apprenticeships started in 2022/23 were level 6 or 7, approximately equivalent to a bachelor’s or master’s degree. This accounted for 28% of all starts in 2022/23, a proportion that has been broadly consistent since 2020/21.

The full time series on the number of starts in life sciences apprenticeships in the UK can be found in this report’s accompanying ‘life sciences competitiveness indicators 2024: data tables’. Details on the data source used and the selection of apprenticeship types to represent ‘life sciences’ can be found in the accompanying ‘life sciences competitiveness indicators 2024: user guide’.

Annex A: Statistics on pharmaceutical expenditure

The LSCIs 2022 report undertook a review of whether a metric should be developed on pharmaceutical expenditure. The result of that review found that there were not currently any suitable data sources that would allow a global comparison for the UK.

How pharmaceutical expenditure influences the goals of improving health outcomes and economic growth (recognising that spend on pharmaceuticals may displace other healthcare provision), was also not evaluated as part of the LSCI review in 2022. Despite this, monitoring pharmaceutical expenditure can also be useful context for understanding how much value for money countries are getting for their spend. This should be looked at within the context of uptake and access to medicines.

For the LSCIs 2024 report the above assessment remains the same so no indicators are present on pharmaceutical expenditure. References to some sources of expenditure are signposted below for interested users.

International sources

Various sources in the public domain attempt to quantify expenditure on pharmaceuticals at an international level, including for the UK:

The OECD statistics only include expenditure on retail pharmaceuticals (i.e. community pharmacies), including prescription and over the counter medicines. Medicines consumed in hospitals and other healthcare settings are excluded. Final expenditure on pharmaceuticals includes wholesale and retail margins and value-added tax, where applicable. Total pharmaceutical spending refers in most countries to “net” spending, i.e. adjusted for possible rebates payable by manufacturers, wholesalers or pharmacies. The OECD statistics are collected from countries in accordance with the framework described in A System of Health Accounts.

IQVIA’s report includes estimated spend for pharmaceuticals in both hospitals and other health care settings in addition to retail pharmacy.

IQVIA’s data source for the UK is based on the Department of Health and Social Care (DHSC) and Association of British Pharmaceutical Industry (ABPI)’s joint Waterfall Analysis of UK medicine sales 2018-21. This analysis estimates the residual between:

  • branded medicines sales at list price (IQVIA data) for medicines supplied to the NHS across the UK
  • sales of branded medicines net of all discounts and distribution costs, but not including the payment made by industry through the VPAS or Statutory Scheme (SS). The net sales data comes directly from VPAS company returns or adjusted IQVIA parallel import data, and will not include VAT, centrally procured vaccine sales (which are excluded from VPAS) or distribution and supply chain elements. Please note that a new voluntary scheme for medicines pricing in the UK, voluntary scheme for branded medicines pricing, access and growth (VPAG), was introduced in 2024 but the listed sources will not have accounted for new medicines spend data under this scheme, given the lag in the data.

The ‘discount/residual’ is the difference between spend at list price and net sales revenues accruing to companies. This difference can be accounted for by distribution costs, pharmacy margins, and discounts off list price; more information is available in the Waterfall Analysis.

The IQVIA analysis takes the sales of branded medicines net of all discounts and the payments made by industry through the VPAS or Statutory Scheme (SS). IQVIA additionally add data for over-the-counter medicines to this total from their data. True net NHS spend is likely to include a proportion of the discount/residual amount, but this is not quantified in the waterfall model. These figures therefore do not account for the additional discount/residual and are likely to understate net spend by the NHS.

IQVIA’s methodology differs for other countries and is summarised in the table on page 35 of the report.

Domestic sources

In addition, the NHS Business Service Authority (NHSBSA) publish official statistics for England on the Prescribing Costs in Hospitals and the Community. Prescribing Costs in Hospitals and the Community (PCHC) shows the actual costs paid for drugs, dressing, appliances, and medical devices which have been issued and used in NHS hospitals in England. This is alongside the cost for the same classes of items that have been issued in other settings in England. This includes:

  • prescriptions issued by GP practices and community prescribers in England that have been dispensed in the community in the UK (excl. Northern Ireland)
  • prescriptions issued by Hospitals in England that have been dispensed in the community in the UK (excl. Northern Ireland)
  • prescriptions issued by dental practitioners that have been dispensed in the community in the UK (excl. Northern Ireland)
  • medicines issued in hospitals in England that have been dispensed via the hospital pharmacy, homecare companies and outsourced out-patient pharmacy partnerships

but excludes:

  • Prescriptions issued through Justice and Armed Services health services in England commissioned by NHSE but not dispensed in the community, this covers pharmacy, appliance, Dispensing Doctors (DD) and Personally Administered Items (PADM).
  • Any medicines issued in hospital in England but not managed via the hospital pharmacy service.

Information on how this data is collected can be found on NHSBSA’s accompanying methodology note.

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