HTA and Payment Mechanisms for New Drugs to Tackle AMR

Neri, M., Hampson, G., Henshall, C. and Towse, A.

Research Paper
September 2019

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Antimicrobial resistance (AMR) is a growing public health threat, limiting the ability of health care systems to prevent and treat infections and save lives. In parallel, global antibiotic development pipelines are weak. Various R&D incentives have been proposed to address the challenges associated to low economic returns from investment in antibiotics. Value assessment methods recognising the value of new antibiotics to the whole health system are needed to help match the size of the required monetary incentives to the value that they offer.

At present, HTA methods for new antibiotics include benefits and costs associated with treating the immediate patient, while ‘public health effects’, such as preventing infection transmission and slowing down AMR development, are not captured. Furthermore, traditional pricing arrangements where revenues depend on volumes sold are unlikely to be profitable, as AMR stewardship will limit the use of the new antibiotic. Use may increase in the long-term when the build-up of resistance means that the antibiotic is used as a first line treatment. However, at that point in time the product may be off-patent and priced as a generic.

This paper provides an overview of the current state of HTA and contracting for antibiotics in five European countries, and of the recent proposals in the literature for revising them. It also includes the recommendations developed following a stakeholder Forum on ‘Value Assessment and Contracting for Antibiotics’ held in February 2019.