Subscription-style contracts for pharma to fund new antibiotics


A scheme to provide new antibiotics to NHS patients by offering to pay pharmaceutical companies upfront for their work will start this week.


The NHS is offering two contracts to pay pharmaceutical companies at the start of their work for access to innovative antibiotics, incentivising them to bring new classes of the drugs to patients across the UK for the first time in almost 30 years.


Of particular interest are antibiotics that can provide alternative treatment options for serious infections, such as bloodstream infections, sepsis and hospital-acquired pneumonia.


The high cost and low returns associated with antibiotic research and development make it commercially unattractive. This is why the drugs will be paid for by the world’s first ‘subscription-style’ payment model for antibiotics and will be made available to UK patients as soon as possible, potentially as early as 2022.


The payment model, which was launched in July 2019, will pay pharmaceutical companies upfront for access to their antibiotic product, based on a product’s value to the NHS, rather than how much is used.


This aims to incentivise companies to invest in researching and developing new antibiotics, helping secure much-needed alternative treatment options for NHS patients.


Two drugs that have proven to be both safe and effective will be selected to undergo health technology assessment (HTA) by the National Institute for Health and Care Excellence (NICE) throughout 2021 using adapted methods for antimicrobials. The HTA will be used to decide the level of the subscription payment.


Health Secretary Matt Hancock said:


“The incredible discovery of antibiotics nearly 100 years ago transformed the health of our nation and our ability to combat infections. Diseases that were once a death sentence are now treated in just one small step.”


“But resistance to antibiotics is increasing and it’s imperative we take urgent action on a national and global scale to protect future generations.


“This new way of buying antibiotics for patients in the NHS breaks down restrictive barriers to offer companies a vital springboard to foster innovation and develop potentially life-saving new products.


Professor Dame Sally Davies, UK Special Envoy on Antimicrobial Resistance, said:


“Antibiotics underpin modern medicine and are integral for global health security. Governments and industry must work together to produce new antibiotics and ensure that we can continue to treat common diseases.


“The UK is leading the way by encouraging companies to produce new antibiotics to stay one step ahead of life-threatening diseases.”


Professor Stephen Powis, National Medical Director, NHS England said:


“Staff across the NHS are already working with patients to ensure the antibiotics we have are used in the right way at the right time, and this new scheme is further important progress to develop new, life-saving antimicrobial medicines.


“People’s lives depend on us having effective antibiotics and steps like this further reinforce how the NHS is leading the way in efforts to safeguard against the rise of superbugs.”


Professor Gill Leng, Chief Executive, NICE, said:


“We are witnessing the effects of one global pandemic, which has highlighted the threat of communicable disease.  Alongside the threat of coronavirus is the increasing risk posed by antimicrobial resistance, exacerbated by a sparse antimicrobial development pipeline.


“That is why we need to incentivise investment in innovative antimicrobial drug development as soon as possible. Along with our key partners, we have committed to develop and test innovative models for the evaluation and purchase of antimicrobials, applying advanced evaluation methods that recognise their full value to public health.


“We hope that this project will inspire healthcare systems across the world to consider adopting similar models so that collectively, we deliver meaningful incentives that reinvigorate the global antimicrobial pipeline.”


This circular is being shared under the Open Government Copyright licence.


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