The proposed new payment method to address antimicrobial resistance involves a fixed annual ‘subscription-style’ fee as opposed to a sum based on how many prescriptions are issued. Image credit: Shutterstock/Vitalii Stock

Amidst rising levels of antimicrobial resistance, the National Health Service (NHS) in England is ramping up plans to lure pharmaceutical companies away from volume-based sales to incentivise research into new treatments.聽

Last year, the NHS initiated a pilot study with antibiotics from and in what was a world-first subscription contract model. After England鈥檚 National Institute for Health and Care Excellence () estimated Zavifecta (ceftazidime鈥揳vibactam) and Fetroja (cefiderocol) value to the NHS, the pharma giants put pen to paper to design a new reimbursement model.

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Now, the NHS has greenlit a consultation to investigate possible expansion to the scheme. Over the next three months, the healthcare service will enlist the help of the pharmaceutical industry, patients, carers, and academics to discuss proposals of doubling annual payments for antibiotic contracts from 拢10 million ($13 million) to 拢20 million ($26 million) where 鈥渙utstanding clinically based criteria are met.鈥�

David Glover, assistant director of medicines analysis at NHS, said: 鈥淎s we continue to take lessons from the Covid-19 pandemic, the development of new antibiotics is absolutely essential to help build resilience to respond rapidly to new superbugs and save lives.鈥�

The proposals include prioritisation of drugs that cover the 12 families of bacteria listed by the World Health Organisation (WHO) that pose the greatest threat to human health. When , the WHO said new antibiotics for bacteria such as Acinetobacter, Pseudomonas, and Enterobacteriaceae are urgently needed.

The scheme is part of a five-year action plan by the UK government to tackle antimicrobial resistance. Stewardship programs prioritise and limit the use of novel antimicrobial drugs to prevent the emergence of resistance. However, the reduced use of novel drugs has resulted in a smaller financial payoff for biotechs developing these drugs. A subscription payment model removes any financial motivation for the overuse of antibiotics, and could also address the lack of new antimicrobials being developed compared to other indication areas, such as immuno-oncology.

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Whilst the UK has managed to , drug-resistant infections in patients are . A indicated that antibiotic resistance leads to 50,000 deaths each year in Europe and the US alone.

Accurately calculating the value of novel medications like new antimicrobials has been a consistent challenge. 聽Talking in a , Nick Crabb, programme director in NICE鈥檚 Science, Evidence and Analytics Directorate, said the institute is encouraging other countries to use learnings from the project to combat antimicrobial resistance on a global scale. 聽The US, for example, has rolled out its own subscription payment models for antiviral treatment of Hepatitis C.