UK Breakthrough Plan for AMR

29 January 2019

GMP News

A new reimbursement model for antibiotics by the NHS and NICE is being labelled as a ‘great breakthrough’.

The model is part of the government’s new national action plan on how it will fight against antimicrobial resistance by 2040. It places more responsibility on the pharmaceutical industry for developing ‘valuable’ medicines. The model will reimburse pharma companies based on the value of their drugs to the NHS, rather than on the amount of antibiotics they sell.

The proposals are to be announced by health secretary Matt Hancock at the World Economic Forum and include plans to cut the number of drug-resistant infection by 5,000 by 2025; reduce the use of antibiotics in humans by 15%, and prevent at least 15,000 hospital associated infections (HIAs) in patients by 2024.

Imagine a world without antibiotics. Where treatable infections become untreatable, where routine surgery like a hip operation becomes too risky to carry out, and where every wound is potentially life-threatening. What would go through your mind if your child cut their finger and you knew there was no antibiotic left that could treat an infection? This was the human condition until almost a century ago. I don’t want it to be the future for my children – yet it may be unless we act.

Antibiotic resistance infections are thought to kill 700,000 people every year, with this figure likely to rise to 10 million by 2050 if no action is taken.

The UK has reduced the amount of antibiotics used by more than 7% but the number of drug-resistant infections increased by 35% between 2013 and 2017.

One part of the plan is to use diagnostics to inform clinicians on when patients require an antibiotic. The idea is that this will help antibiotics stay effective by reducing the number of resistant infections.

However, faster diagnostic tests are currently needed to distinguish between bacterial and viral infections, the latter of which can’t be treated with antibiotics. Diagnostic tests for bacterial infections currently take 48 hours to produce results, meaning there is a danger that infections are treat without the right information.

The action plan has been hailed as a ‘critical step’ in the fight against AMR.

Dr Peter Jackson, executive director of The AMR Centre, said:

Today’s announcement by the UK Government on the launch of a trial to evaluate a new way for the National Health Service (NHS) to pay for antibiotics is the critical step that the world has been waiting for, and is very welcome for AMR researchers.

On the reimbursement model, Jackson stated that current initiatives were problematic, as controlling the use of antibiotics goes against pharma companies profit incentives.

The world needs new safe and effective drugs to treat these dangerous pathogens: but we also need to control their use so that new resistance does not appear. This presents a major problem for drug developers. It takes hundreds of millions of pounds to research and develop a new treatment, but we want to use new antibiotics sparingly, so pharma companies are unlikely to recoup their R&D investment by selling these new life-saving drugs to the NHS as sales volumes will be severely curtailed. The announcement today that NICE and the NHS are now working together with industry to trial a new reimbursement model for these life-saving new medicines to treat AMR is a great breakthrough. This should point the way for other countries around the world to quickly follow suit and introduce their own incentives for antibiotics R&D. This new approach will provide a real boost to the pharma companies developing new AMR medicines, especially the SMEs that are doing the majority of the research work in the UK. It is also an important signal to the private investment community to step back up to the mark and support companies engaged in AMR R&D,” Jackson said.

Dr Nicholas Jones, patent attorney at intellectual property firm, Withers & Rogers, who specialises in the pharmaceutical sector said that the government’s new model “will help to reverse the risk-versus-reward profile of antibiotic research and bring about the step change needed to develop new antibiotic drugs.”

“However, real change in this area will only happen when other governments around the world also act, and the UK could potentially lead the way,” Jones said.

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