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Plenty of ink has been spilled on the issue of Scottish independence. And rightly so. A Yes vote in the referendum will utterly redefine how politics works north and south of the border. Even a No vote will lead to huge changes in the constitutional settlement. With significant powers being devolved to Scotland in the event of a No vote things will need to change south of the border too. However, little has been written about the possible impact of this on the pharmaceutical industry in the UK.

Although most health policy has been devolved to Scotland there are some elements that have remained with London. The most significant health related reserved powers are on medicines, medical supplies and the regulation of health care professionals.

The issue of maintaining a reserved responsibility for medicines pricing in London with devolved health systems recently reared its head during the recent Pharmaceutical Pricing Regulation Scheme (PPRS) negotiations. The voluntary agreement was notionally negotiated between the ABPI and the Department of Health in Westminster. The final document was signed up to by the Scottish Government as well as the administrations in Northern Ireland and Wales.

A No vote will lead to negotiations on the devolution for further power to the Scottish Parliament. At the moment discussion has revolved around devolution of welfare, spending and taxation. There, of course, has been no mention of medicines pricing given the enormity of the issues being contemplated. This is unlikely to change and medicines pricing is unlikely to feature in negotiations. In addition, in the event of a No vote the different health technology appraisal arrangements that are in place for Scotland will remain.

Obviously, if there is a Yes vote on Thursday responsibility for everything health related goes to Scotland. This raises a number of interesting possibilities. The Scottish National Party (SNP) has already said that it sees the pharmaceutical industry as a key strategic industry for Scotland. Given the likely negative short to medium term economic impact of independence there is a good chance it will look to the pharma industry for inward investment.

Scotland doesn’t have to look far for a successful model. Ireland has developed a very strong pharmaceutical and life science industry through a combination of a low tax regime, skilled graduates and research and development investment. There is a strong chance that an independent Scotland might go down this route. Indeed a more favourable medicines pricing system could be a component of a package for the pharmaceutical industry to attract life sciences investment across the border.

Questions, however, have been raised about the financial positions of a newly independent Scotland. There is some uncertainty about currency, national debt and revenue raising. This has been central to debate about the referendum. There is the potential in the short to medium term for an independent Scotland to reduce public spending. If this happens it will impede the ability of the Scottish health system to pay for innovative new treatments and to invest in research.

Overall the impact of a No vote on industry is likely to be low. However, companies will need to start contemplating what to do in the event of a Yes vote. With Scotland to become independent in March 2016 if there is a Yes vote, change will come sooner rather than later.