Peers warned that charging VAT on medicines donated through compassionate use and early-access schemes could reduce access for patients with rare cancers and other serious conditions; the Government said the tax treatment is long-standing, promised to work with HMRC, companies and charities on a quick patient-focused solution, but gave no figures on patients affected or revenue expected.

Ministers said rare cancers are now part of the national cancer plan, with expanded genomics, faster clinical trial set-up and new regulation for rare-disease treatments, but peers challenged delays in testing, access to trials through the NHS app, NICE evidence rules and possible VAT risks to free early-access medicines.