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All eyes on a new subscription model for antibiotic development

By Richard Stabler

Regular readers of the AMR Centre Newsletter may remember that in January 2018, we reported on the UK government’s announcement that – as one of several measures to support new strategies to combat AMR – a novel economic model was being considered. The idea was to uncouple profit from volume of antibiotics sold in order to incentivise pharmaceutical companies to invest once more to develop new compounds. The proposed solution was a ‘subscription model’ that would see companies reimbursed for their investments by an annual fee paid by the NHS based on the value of those drugs as modelled by health technology assessment.

The scheme has since been incorporated in the UK’s five year national action plan on antimicrobial resistance, which set targets to reduce human use of antibiotics in the UK by 15% by 2025. NHS England, the Department of Health and Social Care, and the National Institute for Health and Care Excellence will test the new model to assess the added value of any new antimicrobials. The work will then be evaluated and shared with the rest of the world so that other healthcare systems can test similar models.

The LSHTM AMR Centre have prepared an editorial comment, published last week in the BMJ, in response to this announcement. We welcome the new investment in helping to get new drugs to market – but we are cautious that this does not come at the expense of other initiatives that are proven to be effective, including public health, social and structural interventions.

The UK is the first country to attempt such an innovative model, and the trial will be watched with interest across the world to see if it stands as a cost-effective tool that can bring new resources to bear against AMR.

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