The National Institute for Health and Care Excellence (NICE) has issued new guidance for an innovative new subscription payment system for antibiotics. The scheme is designed to help combat the growing resistance to antibiotics that is developing worldwide.

The Financial Times reports that the UK is the first country in the world to introduce the scheme, which will pay a predetermined fee to pharmaceutical companies in order to provide an incentive to develop new drugs.

Antimicrobial resistance (AMR) is a serious global problem, the World Health Organisation (WHO) reports. The overuse and inappropriate use of antimicrobials (an umbrella term for medical antibiotics, antivirals, antifungals, and antiparasitics) has led to the development of drug resistant viruses and bacteria.

When untreatable or harder to treat pathogens develop—so called ‘superbugs’— it allows disease to spread more quickly. This results in longer stays in hospital, and greater rates of death and disability. It also increases the risks involved in major surgery and chemotherapy.

AMR has a severe financial impact, in terms of more expensive healthcare and lost productivity due to sickness. There has been a shortage of new antimicrobials in clinical development in recent years, with WHO listing 32, of which only six proved to be effective. This compares to about 1,800 new drugs developed for cancer treatment.

The new system will involve the NHS paying the drug companies Pfizer and Shionogi a subscription of £10m a year, in return for antibiotic research and development. It is hoped that the governments of other leading economies will also follow suit.

The Association of the British Pharmaceutical Industry (ABPI) has welcomed the news. Richard Torbett, Chief Executive of the ABPI said: “This is an important milestone in the UK’s global leadership on AMR. Antibiotics underpin modern medicine, but the increasing threat of antibiotic resistance remains one of the biggest global health challenges we face.”

He added: “To tackle this, it is critical that the appropriate frameworks are in place for companies to invest the billions of pounds required to discover the new antibiotics needed for patients.”

“We acknowledge the difficulties of generating evidence on the broader public health benefits that antibiotics bring to patients, but it is essential these are fully captured in evaluation frameworks. Rapid progress is needed to establish a permanent evaluation and reimbursement approach and deliver the incentives needed to develop these important medicines.”

Two new drugs are already set to become available to treat cases of serious drug-resistant infections. These are cefiderocol and ceftazidime–avibactam, according to NICE. The new drugs will be strictly controlled, in an effort to try and prevent the overuse that has led to the evolution of superbugs.

Nick Crabb, programme director in NICE’s science, evidence and analytics directorate, said: “Its ultimate goal is to ensure the NHS has access to effective new antimicrobials to call on when needed and patients aren’t left without treatment options in the face of growing antimicrobial resistance.”

Mr Crabb emphasised the importance of other countries offering similar incentive schemes, and said that the UK only represents 3% of the global market. Therefore, NICE is sharing information to help bring about further collective global investment in antimicrobials.

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