Cancer patients are not being given access to ground-breaking treatments because the system of funding drugs in England is "really broken", the head of a major pharmaceuticals company has said.
Erik Nordkamp, managing director for Pfizer UK, said the country is "hostile" to innovative breakthroughs and is failing to keep pace with Scotland and Germany.
He said the system used by the National Institute for Health and Care Excellence (Nice) to approve drugs is out of date and warned against reforming the cancer drugs fund, which can step in to fund treatment that the health watchdog has not appraised.
He told BBC Radio 4's Today programme: "The system is really broken."
"The system that is used in England is coming up with a different output than the system in Scotland, than the system in Germany, than the system in many other countries and that is really the problem," he added.
"That is why the system is broken. It needs to be reassessed."
Mr Nordkamp denied his company was trying the hold the health service to ransom, insisting his comments were not a "threat".
He said: "The price you are getting is a good deal, you are getting a good deal. But still with those prices you are not getting the medicines through the system.
"The survival rates in the UK compared to other countries are really lagging behind in terms of outcomes. To be fair, there are also other parameters that play a role in that, for example how quickly you get diagnosed."
Mr Nordkamp said research and development in the sector in the UK is falling and said it was a "fairly hostile environment for the uptake of innovative medicines".