Incentivising Pharma to tackle AMR

Following numerous recent reports on the threat posed by antimicrobial resistant drugs, Health Business examines the recent deal the NHS made with Pharma to kickstart the development of drugs to fight hospital superbugs

According to data from Public Health England, around 65,000 people a year develop drug-resistant infections, known as “superbugs” and experts have warned that the problem is getting worse, leading to fears that even common procedures could become deadly if more treatments become ineffective.

Subscription Deal
Following the announcement of a new “subscription” deal, the NHS is set to roll out two “superbug-busting” drugs in an effort to fight Antimicrobial Resistance (AMR).
    
The deal has initially been signed for two antimicrobial drugs, which means that those with serious infections that have evolved so much that current treatments including antibiotics are no longer effective, could receive a potentially life-saving alternative.
    
As increasing numbers of people are developing drug resistance, the new drugs will be used to treat life-threatening infections including sepsis, hospital or ventilator pneumonia and blood stream infection.
    
Around 1,700 patients a year will be eligible for the drugs.
    
NHS chief executive Amanda Pritchard said: “Superbug-busting drugs on the NHS will save lives and strike a blow in the global battle against antimicrobial resistance.
    
“Until now, innovation in antibiotics has been limited, but this pioneering NHS subscription scheme aims to turn the tide by working with pharmaceutical firms to make sure we have these superbug-battling drugs ready and available to those patients who need them most.”

Long Term Plan commitment
The deal has been developed as a result of a UK-wide project with NHS England, NICE and The Department of Health and Social Care. According to NHS England, the deal meets a key commitment of the NHS Long Term Plan to support the implementation and delivery of the government’s five-year action plan on antimicrobial resistance. This includes supporting the development of new antimicrobials.
    
Other antimicrobial resistance goals in the NHS Long Term Plan include optimising use, and reducing the need for and unintentional exposure to antibiotics.
    
Another part of the Long Term Plan covers striking deals for world-leading drugs and helping to increase innovation.
    
NHS medical director, Professor Sir Stephen Powis, said: “This is a huge milestone in the country’s quest to tackle the increasing global threat of antimicrobial resistance and it is fantastic that the NHS has been able to lay down the footprint to tackle this and deliver a revolutionary deal two years ahead of the target set out by Government in 2019.
    
“Tens of thousands of people suffer from drug-resistant superbugs every single year in England and this deal will offer hope to those who have had limited or no success with current treatments”.

How it works
The scheme will work by paying pharmaceutical firms a fixed yearly fee to incentivise funding for innovation to generate a pipeline of new antibiotics for NHS patients. The yearly fee will be capped to represent value for money for taxpayers, with the NHS paying up to £10m a year for up to 10 years.
    
The idea behind incentivising innovation in antimicrobial drugs to tackle superbugs is that pharmaceutical companies are not paid based on the number of drugs bought or prescribed. As the drugs will be subject to stricter rules on who is able to receive them to ensure they continue to work effectively, pharmaceutical companies are incentivised to produce better treatments rather than more treatments.
    
The two drugs available are cefiderocol manufactured by Shionogi and ceftazidime–avibactam, manufactured by Pfizer.

First-of-its-kind deal
According to NHS England, this is the first time any health system in the world has successfully assessed the value of an antimicrobial in this way. The agreement aims to ensure that drug manufacturers are working in partnership with the NHS to protect the longevity and effectiveness of the drugs.
    
As the scheme is the first of its kind in the world, it is hoped that other countries will follow the lead and antimicrobial drug innovation will be incentivised globally. As AMR poses a global threat to modern medicine and public health, global innovation and cooperation are needed to fight it.

Amanda Pritchard said: “We have shown through the course of the COVID-19 pandemic the power of working together, combining our expertise across industries, in order to tackle emerging risks – whether that is COVID-19 or the very real threat of antimicrobial resistance – head on”.

As mentioned in the previous article, with the ever-growing threat of AMR, a multi-pronged approach is needed. In conjunction with other initiatives, incentivising pharmaceutical companies to produce new drugs is a good thing. However, with the amount of money being spent, leaders must make sure that the investment actually produces results and pharmaceutical companies aren’t just sitting on their laurels.