James Dennis | 22/11/2024
The Alliance for Reducing Microbial Resistance have examined the expected return on investment for pull incentives for new antimicrobials. Pull incentives are increasingly being explored to break the deadlock in the antimicrobial market, by considering alternative approaches to reward manufacturers, delinked from the volume of sales, for bringing much needed antimicrobials to market. These incentives aim to encourage investment into the antimicrobial market and reinvigorate the clinical pipeline.
The failure of the antimicrobial market is driven, in part, by the approach of traditional health technology assessment, which focuses on individual patient outcomes and does not sufficiently quantify the broad population-level value of antimicrobials. This has been described with the STEDI value framework (spectrum, transmission, enablement, diversity and insurance). The success of pull incentives, whether these take the form of subscription programmes, transferable exclusivity extensions or other novel reimbursement models, depends upon quantifying the true value of new antimicrobials to healthcare systems. A global pull incentive needs to be large enough to encourage private investment to drive a healthy and innovative antimicrobial pipeline. Understanding the full value of antimicrobials is necessary to inform policy makers on the return on investment of pull incentives, allowing informed decisions on funding. Whilst it is important for governments to make investments that reflect their “fair share” of a global pull incentive and offer a healthy return on investment, there needs to be serious consideration of how a global pull incentive can support access of new medicines to low- and middle-income countries, who may not be able to afford the same investment but are disproportionately affected by the impact of antimicrobial resistance. Similarly to other global crises, like climate change, tackling antimicrobial resistance requires a co-ordinated global response.
At HEOR, we have been collaborating with strategic partners to develop novel approaches to quantifying the burden of antimicrobial resistance, including an innovative modelling framework exploring the STEDI value of new antimicrobials. Through initiatives like these, we aim to support patient access and optimise commercial success.