New AMR strategy revamps drug payment model

The UK government has revealed its new action plan for controlling antimicrobial resistance.

NHS England and the National Institute for Health and Care Excellence (NICE) will explore a new payment model that pays pharmaceutical companies based on how valuable their medicines are to the NHS, incentivising the development of new and innovative antimicrobial drugs.

On announcing the new plan, Health and Social Care Secretary Matt Hancock called AMR as big a danger to humanity as climate change or warfare and called for an urgent global response.

“Each and every one of us benefits from antibiotics, but we all too easily take them for granted, and I shudder at the thought of a world in which their power is diminished,” he said.

Currently, pharmaceutical companies face the dilemma that their new high-investment superdrugs are going to be sold directly to the NHS and used as sparingly as possible, meaning sales volumes will be dented.

Efforts are being made to delink the correlation between phrama revenues and the volume of drugs sold, by way of new incentives that reward drug innovation.

Dr Peter Jackson, Executive Director of The AMR Centre, which coordinates research into new antibiotics in the UK, called the new plan a critical step in the fight against AMR.

“This new approach will provide a real boost to the pharma companies developing new AMR medicines, especially the SMEs that are doing the majority of the research work in the UK. It is also an important signal to the private investment community to step back up to the mark and support companies engaged in AMR R&D."

700,000 deaths globally per year from a drug-resistant infection: Dr Peter Jackson on AMR at Lab Innovations 2018

Without appropriate action, antibiotic resistance is predicted to kill 10 million people every year by 2050. The number of drug-resistant bloodstream infections, for example, increased by 35% from 2013 to 2017.

“At the moment, older antibiotics are mainly generic drugs, sold cheaply and with wide availability, uncontrolled in some areas of the world,” Dr Jackson said. “That’s one of the reasons why microbes have evolved rapidly to be resistant to the most common classes of antibiotics in the medicine cabinet. And with international mobility, these resistant microbes can spread rapidly around the world.

Without effective antibiotics, everyday medical procedures like caesarean sections or hip replacements could become too dangerous to perform.

Clinicians are now seeing superbugs that are resistant to more than one type of antibiotic or even resistance to all of them. This has lead to cases such as the recent super-gonorrhoea infection in two UK women.

The announcement from the NHS should point the way for other countries around the world to quickly follow suit and introduce their own incentives for antibiotics R&D.

Dr Chris Doherty, managing director of Alderley Park in Cheshire, which has businesses working on new antibiotics, said; “It’s very welcome news that the market failure in antibiotic drug development is being addressed by the new government strategy.

“AMR is a complex challenge but science can only seek to solve it if the funding mechanism for this unique problem is overhauled. The consequences of failure to do so would affect us all.”

Another major focus of the new plan – which also covers animals and the environment – is to reduce the number of resistant infections and supporting clinicians to prescribe appropriately. Under the strategy, the use of antibiotics in humans will be reduced by 15%.

The government will make use of new technology to gather patient data, in order to help clinicians know when to use and preserve antibiotics in treatment.

Further targets include cutting the number of drug-resistant infections by 10 percent by 2020 and preventing at least 15,000 patients from contacting infections as a result of their healthcare per year by 2024.