Two new antibiotics may soon be available to patients under ‘subscription-style’ incentive scheme

Commercial discussions have started between NHS England and the manufacturers of cefiderocol and ceftazidime around subscription-style payments for use of the medicines.
Hand with intravenous drip attached

Patients with severe drug-resistant infections may soon be able to benefit from two new antimicrobial drugs as part of the UK’s new ‘subscription-type’ payment model, claims the National Institute for Health and Care Excellence (NICE).

On 12 April 2022, NICE published draft guidance recommending cefiderocol (Fetcroja; Shionogi) and ceftazidime with avibactam (Zavicefta; Pfizer) for the treatment of severe aerobic Gram-negative bacterial infections.

Based on these evaluations, commercial discussions have begun between NHS England and the drug manufacturers to offer subscription-style payments, which would pay pharmaceutical companies a fixed annual fee for use of the medicines, regardless of how many prescriptions are issued.

The scheme, originally announced on 9 July 2019, has been designed to make it more attractive for companies to produce new antibiotics and counter the growing threat posed by antimicrobial resistance (AMR).

A study published in the Lancet in January 2022 highlighted that AMR was the leading cause of death around the world, with an estimated 4.95 million deaths associated with bacterial AMR in 2019. The authors said understanding the burden of AMR and leading pathogen-drug combinations was “crucial” to making informed decisions, particularly about infection prevention and control programmes, access to essential antibiotics, and research and development of new vaccines and antibiotics.

NICE will issue its final guidance once commercial negotiations have concluded but has said that the drugs will only be used to treat patients with severe drug-resistant infections who would otherwise have limited or no other treatment options.

Nick Crabb, programme director in NICE’s science, evidence and analytics directorate, said: “This draft guidance represents an important milestone in the UK project.

“Its ultimate goal is to ensure the NHS has access to effective new antimicrobials to call on when needed and patients aren’t left without treatment options in the face of growing antimicrobial resistance.”

Richard Torbett, chief executive of the Association of the British Pharmaceutical Industry, also described the announcement as “an important milestone” in the UK’s global leadership on AMR.

“Antibiotics underpin modern medicine, but the increasing threat of antibiotic resistance remains one of the biggest global health challenges we face,” he said.

“To tackle this, it is critical that the appropriate frameworks are in place for companies to invest the billions of pounds required to discover the new antibiotics needed for patients.”

Last updated
The Pharmaceutical Journal, PJ, April 2022, Vol 308, No 7960;308(7960)::DOI:10.1211/PJ.2022.1.138523

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