A Netflix-style scheme to fund new antibiotics through a subscription 鈥� through which the health service pays drug companies a set annual fee, regardless of how many doses are used 鈥� will start next year in England.
The approach tackles a key element of the antibiotic resistance crisis: that few new drugs are being developed, while existing ones are failing. The field is currently unprofitable for pharmaceutical firms because when new antibiotics reach the clinic, health services use them sparingly, to slow the spread of bacterial resistance.
Under the new scheme, manufacturers Pfizer and the Japanese firm Shionogi will receive fixed payments from England鈥檚 National Health Service from April for two recently launched antibiotics, called Zavicefta and Fetcroja, respectively.
Advertisement
The amount to be paid hasn鈥檛 yet been announced, but the UK government has previously said it could be as much as 拢10 million a year. 鈥淚t doesn鈥檛 matter if we use no pills, one pill or 10,000 pills,鈥� says at , a charity that wasn鈥檛 involved in the scheme. 鈥淸Funding] is not at all related to the number of antibiotics used.鈥�
Bacterial resistance to antibiotics, used to treat conditions such as pneumonia, sepsis and wound infections, is seen as one of the biggest threats to public health. Resistant microbes have become more common as antibiotic use has increased, raising the prospect that simple infections will become untreatable, and common operations and cancer treatments will be far riskier.
For years, various schemes have been debated to try to provide an incentive for companies to do research and development in this field. The UK subscription model is the first designed explicitly to reimburse firms an amount that reflects an antibiotic鈥檚 overall value to the health service, even if it is kept as a medicine of last resort and used little.
鈥淚f you have a patient in hospital with a resistant organism, it can totally disable an entire ICU,鈥� said a clinical advisor for the . Leonard was speaking at a conference yesterday held by the UK Royal Society of Medicine called Spotlight on Antimicrobial Resistance: A slow pandemic.
NICE has recently completed an assessment of Zavicefta and Fetcroja for the purpose of the subscription model. is a combination of two drugs for treating conditions such as pneumonia and urinary tract infections. is aimed at infections caused by a hard-to-treat group of microbes called aerobic Gram-negative bacteria. The drugs are supposed to be prescribed only if the infection fails to respond to other antibiotics.
The US Senate is considering a similar plan, set out in a bipartisan bill called the Pasteur Act, through which the government would pay companies annual sums for new antibiotics based on their novelty and clinical value. 鈥淭hat would be a game changer,鈥� , former chief medical officer for England, said at the conference.
Sweden has also begun trialling a scheme that offers five antibiotic manufacturers minimum guaranteed payments for their drugs. This is designed to encourage firms to make existing antibiotics available in Sweden, because the country uses less antibiotics per head than similar high-income countries.
