We have not made a specific assessment of the potential impact of changes to 2019 Voluntary Scheme for Branded Medicines Pricing and Access (VPAS) payment percentages on late-stage clinical trials and access to new medicines. An assessment relevant to these issues was published in December 2022 on the impact of changes to payment percentages in the associated Statutory Scheme for Branded Medicines. Changes to the VPAS payment percentages reflect the scheme working as intended to adjust for increased sales of branded medicines to the National Health Service and are below the rate projected when the Scheme was agreed with industry in 2018. The NHS has delivered a record number of access agreements since VPAS was agreed including many world and European-first agreements. The NHS has delivered world-leading uptake of some of the most important cancer and rare disease drugs, while also agreeing deals for a number of new cell and gene therapies.