OHE presented at the Global AMR R&D Hub Board of Members Meeting in Paris, on adapting HTA and payment mechanisms to incentivise new drugs to tackle AMR. This presentation was based on research by OHE, funded by the Wellcome Trust.
On 31st October 2019, Adrian Towse and Chris Henshall presented at the Global AMR R&D Hub Board Meeting in Paris.
The topic of their presentation was HTA and payment mechanisms for new drugs to tackle antimicrobial resistance. Specifically, after introducing the challenges of applying standard health technology assessment (HTA) and contracting methods to antibiotics, they discussed a number of proposals that have emerged in the academic literature and made pragmatic recommendations to progress the practical adoption of these potential solutions. The slides from their presentation can be viewed below.
This presentation draws on research by OHE, funded by the Wellcome Trust, on innovative HTA methods and contracting for antibiotics. A short four-page summary of the research was circulated at the meeting and is available to download as a PDF. Among the main findings of this work are that:
- Governments and funding institutions should continue to advocate for changes to HTA and to contracting for antibiotics around the world, and particularly within Europe. The European Network for Health Technology Assessment (EUnetHTA), or successor bodies, could be tasked with a role in developing a joint assessment of a new antibiotic, thus hopefully stimulating independent action. Countries gaining first-hand experience with innovative HTA and contracting for antibiotics, like the UK, should share the learnings with other countries, to contribute to the common understanding of the most effective policy interventions.
- HTA approaches to assessing antibiotics need to reflect the public health elements of value that new antibiotics bring to patients and to the health care system. RCT evidence from registration trials will not provide evidence of superiority, which will need to be estimated using other sources of evidence. The elements of value that are most relevant for particular types of antibiotics and usage scenarios should be identified and expert elicitation should be used to inform modelling. The advanced modelling approaches that are used for vaccines could be transferred to antibiotics to model the patterns of transmission and herd immunity.
- Contracting for new antibiotics needs to move away from ‘price x volume’ agreements to delinking payments from volumes sold. In the short term, new antibiotics should be excluded from DRG-bundled payments to disincentivise the use of cheaper drugs when more expensive ones may be appropriate. ‘Volume-delinked’ payments will provide a longer-term solution because they will encourage better adherence to stewardship.
The full report of the study is available here.
Related research
Neri, M., Hampson, G., Henshall, C. and Towse, A., 2019. HTA and payment mechanisms for new drugs to tackle AMR. OHE Research Paper, London: Office of Health Economics. RePEc.
Ferraro, J., Towse, A. and Mestre-Ferrandiz, J., 2017. Incentives for New Drugs to Tackle Anti-Microbial Resistance. OHE Briefing. London: Office of Health Economics. RePEc.
Karlsberg Schaffer, S., West, P., Towse, A., Henshall, C., Mestre-Ferrandiz, J., Masterson, R. and Fischer, A., 2017. Assessing the Value of New Antibiotics: Additional Elements of Value for Health Technology Assessment Decisions. OHE Briefing. London: Office of Health Economics. RePEc.
