In recent months, England introduced guidelines for free-of-charge medicine schemes to ensure consistency across integrated care systems. These guidelines aim to prevent distorted geographical prescribing patterns. Omar, with extensive experience in the UK, recalls some companies offering free medicines until NICE evaluations were completed, leading to tensions between clinicians and payers over potential future liabilities. The new guidelines aim to prevent localised free-of-charge offers, but keeps the door open for manufacturers to offer national national schemes.