UK launches world's first ‘subscription-style’ payment model for antibiotics

A government scheme to fuel the development of new antibiotics 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, as a means of incentivising the development of new classes of these drugs to patients across the UK for the first time in almost 30 years.

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

Development of antibiotics isn't particularly commercially attractive as the field is linked with high cost and low returns. Consequently, few new classes of antibiotic have been discovered since the 1980s and, for most antimicrobials, there are few replacement or alternative products in development and even fewer that target priority pathogens.

This has spurred the introduction of the world’s first ‘subscription-style’ payment model for antibiotics.

Under the model, pharma companies will be paid upfront for access to their antibiotic product, based on its value to the NHS as opposed to how much is used, in the hope that this will encourage new research and development.

“Resistance to antibiotics is increasing and it’s imperative we take urgent action on a national and global scale to protect future generations,” said health and social care secretary Matt Hancock.

“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.”

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

“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,” commented Professor Gill Leng, NICE's chief executive.

“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.”