Looking back…
Go back fifty years, and the main conditions occupying UK healthcare organisations were cardiovascular disease, malignant cancers (especially lung cancer), stroke and infectious bacterial diseases. APIs seen as “new” were small molecule neoplastics, anti-inflammatories as well as beta-blockers for rising hypertension, stroke and heart risks. With the expansion of vaccines for measles, mumps and rubella one could point to an industry alignment with national priorities.
The current focus…
In 2026, the picture is slightly different. Cardiometabolic diseases with rising rates of obesity and earlier onset of type 2 diabetes are the UK’s “slow-burn” crisis. The good news is that their management are being transformed by newer therapies. Mounjaro (tirzepatide), and Ozempic (semaglutide) are well-established with gene-targeted lipid regulators finding their clinical place.
A lack of alignment?..
However, one could ask if a divergence is developing between R&D pharma and national healthcare priorities. In 2026, pharma's lens is on high-value chronic therapies where today’s R&D bears little resemblance to past approaches. Think GLP-1s (diabetes), immunotherapies including CAR (Chimeric Antigen Receptor) T-cell therapy (oncology), anti-amyloid/disease-modifying therapies for neurodegenerative diseases (e.g. Alzheimer’s).
On the other hand, national healthcare systems prioritise mental health, antimicrobial responsibility and accessible treatment of core diseases (e.g. cardiovascular/hypertension) using generics. The crisis facing the NHS, government funding decisions, and a growing aging population all expose the gaps between industry direction and low-margin “health epidemics”. If there is a mismatch, then aligning industry R&D with public burdens needs to be addressed collaboratively.
Sleeping Giants…
Maybe a starting point for that collaboration is identifying some of the “ticking time-bombs” likely to hit the future health of the nation. Whilst cancer, diabetes and heart disease are already clearly in view, it’s a list with perhaps a few surprising entries:
Driven by obesity, diabetes and sedentary life-styles, non-alcoholic fatty liver disease (NAFLD) is predicted to become the leading cause of liver disease with two-thirds of UK adults at risk.
With similar linkages to diabetes, hypertension, and ageing, chronic kidney disease (CKD) is seen as a “silent killer” given it is largely asymptomatic in early stages. Dialysis needs are expected to grow by 400% by 2033.
It might be odd to consider sarcopenia (muscle loss) as something other than “an old person’s disease”, but frailty in mid‑life is of increasing concern to frontline healthcare. Starting in middle age and exacerbated by sedentary lifestyles, the impact on long-term health, social care, and economic costs is expected to be considerable.
And finally, attention deficit hyperactivity (ADHD) in adults and considered to be significantly under-diagnosed; a true sleeping giant sitting at the intersection of mental health, neurology, and social care with no single system owning it.
If ever there was a time for interested parties to address issues of profit versus disease prevalence, innovation versus affordable access and 15-year R&D cycles versus the needs of today, then surely it is now.
