UK launches world-first ‘subscription’ model for antibiotic supply

NHS England aims to conclude innovative “subscription-style contracts” with pharmaceutical giants Pfizer and Shionogi to pay a fixed ‘subscription’ fee for supplying antibiotics, in an effort to tackle the growing global crisis over antimicrobial resistance (AMR) later this year.

Under the deal being struck by the NHS with Pfizer of the US and Shionogi of Japan, the drug companies will be paid a fixed annual fee for at least three years, rather than the NHS buying each dose separately.

The payment model, the first of its kind, is designed to incentivise companies to make drugs of this kind even though they are rarely used and would not generate large profits.

The current reimbursement system based on sales volume often fails to provide sufficient revenue to justify research and development spending.

Several European nations and the US are considering similar schemes that separate payment from prescription volume, either through an upfront market entry payment or annual subscriptions like the NHS England model.

Blake Dark, the NHS commercial medicines director, quoted in The Times newspaper, said:

“This is an important step in our world-leading approach to incentivise innovation in antimicrobial drugs and the battle against drug-resistant infections.

“The NHS will now use its commercial power to secure deals that will enable patients to benefit from these treatments, paving the way for a pipeline of future treatment options.”

The National Institute for Health and Care Excellence (Nice) said that the drugs, cefiderocol and ceftazidime with avibactam, offered value for money and would save the lives of patients who had no other options.

They are designed to help patients with severe drug-resistant infections including cases of pneumonia and sepsis.