UK tests ‘Netflix Subscription Model’ for new antibiotic drugs

03 Jul 2020

The UK Department of Health and Social Care (DHSC) recently announced a new approach for the procurement and provision of new antibiotics in the NHS, through a subscription-style’ payment model. The news represents a total re-think of how antibiotics are valued in public health.

The proposed payment model is the first time that antibiotics are being sold under contracts that are based on the population covered as opposed to the number of pills sold. Not only does this demonstrate a recognition of the need for new antibiotics but simultaneously signifies the creation of a new system which uses them sparingly. It incentivises antibiotic innovation, at the same time decoupling its financial viability from the number of doses prescribed, promoting stewardship over volume.

Throughout 2021, the National Institute for Health and Care Excellence (NICE) will apply advanced evaluation methods to assess two drugs, which will be used to decide the level of the subscription payment.

By disrupting the inertia in the system like this, the government is sending a strong signal to the market that antibiotics are valued for their greater impact including lives saved and eliminating or shortening hospital stays. If more countries adopt this approach of contracting for population coverage of antibiotics at compensation levels that reflect these product public health value, the global market for antibiotics will begin to stabilise and become more attractive to developers and producers.

New antibiotics are long overdue and essential, but we know that they will promote eventual bacterial resistance if they are not targeted effectively. The question of knowing when to prescribe which antibiotics remain undervalued. Now that the government has this antibiotic element of the system in place, we argue that it is time to devise the companion diagnostic piece of the puzzle. A similar system can be used to incentivise new, much-needed diagnostic tests that will help steward the long-term use of precious antibiotics for the years to come.