Aligning industry incentives with AMR control goals: Exploring the feasibility of an antibiotic susceptibility bonus for drugs to treat Gram-negative infection

Interventions

Therapeutics

Research Project: 2017-12-01 - 2020-11-30
Total sum awarded: €445 482

High prices create incentives for industry to develop new antibiotics, but also incentivize firms to promote their products to maximize sales volume. Similarly, the Market Entry Rewards proposed by the O’Neill Commission and others will, if introduced, help to get new drugs to market but do not directly address the problem of antibiotic overuse leading to emergence and spread of antimicrobial resistance (AMR) (O’Neill 2016). The multidisciplinary study proposed here explores the feasibility of a finance-based intervention intended to directly re-align pharmaceutical industry interests with the minimization of AMR and with the overall prolongation of antibiotic efficacy through time. The proposed intervention allows pharmaceutical companies to qualify for staged bonuses if pathogen susceptibility to their antibiotic remains above a given threshold, despite a certain minimum volume of usage. This Antibiotic Susceptibility Bonus may help maximize efforts towards good prescribing practice and towards minimizing the risk of acquisition, development and transmission of antibiotic-resistant Gram-negative bacteria. The lure of a bonus greater than expected revenues from unit sales could help align efforts behind antibiotic stewardship and infection prevention efforts in hospitals, communities, agriculture, and the environment, bolstering public and private AMR initiatives across One Health sectors. This project will evaluate the feasibility and potential impact of the Antibiotic Susceptibility Bonus. It will address the difficulties involved in: i) developing a general measure of susceptibility; ii) calculating optimal bonuses based on realistic market considerations; iii) assessing product utility and accessibility. This will be done through 2-3 case studies of actual late stage (Phase III) candidate antibiotics and an existing product with particular antimicrobial features – each targeting multi-resistant Gram-negative bacteria

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  • Aidan Hollis, University of Calgary, Canada (Coordinator)
  • Stephan Harbarth, University of Geneva, Switzerland (Partner)
  • Olof Lindahl, Uppsala University, Sweden (Partner)

Resistance to antibiotics makes them less effective over time. The preservation of antibiotics requires efforts from all stakeholders. Thus far numerous initiatives have been put in place to improve prescribing by physicians, enhance formalities surrounding dispensing by pharmacists, and encourage regimen adherence by patients, inter alia. The last stakeholder to come on-board are the developers who make these badly needed products. Due to a very traditional marketplace these companies are still incentivized to sell as many units of antibiotics as possible – even of the newest ones that we so badly need to conserve. This multidisciplinary study explored the feasibility of a finance-based intervention intended to directly re-align pharmaceutical industry interests with the minimization of antimicrobial resistance and with the overall prolongation of antibiotic efficacy through time. The proposed scheme allows pharmaceutical companies to qualify for staged bonuses if pathogen susceptibility to their antibiotic remains above a given threshold, despite a certain minimum volume of usage. Entitled the Antibiotic Susceptibility Bonus (ASB), this scheme would in theory help maximize efforts towards good prescribing practice and towards minimizing the risk of acquisition, development and transmission of antibiotic-resistant bacteria. The lure of a bonus greater than expected revenues from unit sales could help align efforts behind antibiotic stewardship and infection prevention efforts in hospitals, communities, agriculture, and the environment.

Call

2017 - Prevention and Intervention Strategies to control AMR infections