The Government has announced some details of an NHS pilot scheme to test an alternative, “subscription” reimbursement model for use of novel antibiotics on the NHS.
The antimicrobial resistance (AMR) scheme, announced today by the Department of Health and Social Care (DHSC) is to be jointly managed, with the programme assessed by National Institute for Health and Care Excellence (NICE), and supported by NHS England and NHS Improvement.
The programme is expected to include two products, to be selected by the end of the year, with the programme running for approximately the duration of 2020.
“If a company has not yet notified NICE and NHS England & NHS Improvement of a product to be considered, they should get in contact with ABpaymentmodels@nice.org.uk”
– programme launch statement
Positive MAP InsightsFurther detail on the programme is available within the programme launch statement, available on the NICE Antimicrobial Prescribing Guidelines page.
The proposed subscription approach involves the NHS being given access to a drug for a defined period, and the developer provided with a payment based on the value the drug has offered, even it is reserved and not used.
This effectively reimburses value rather than volume, to create an environment in which development of reserved and conserved antibiotics can be commercially viable. A key objective will be to test the payment model and develop a health-economic approach to calculating appropriate payments.
The nine main workstreams of the project can be summarised as follows:
- Phase one:
- Development of an evaluation framework
- Development of a framework for negotiating levels of delinked payments
- Identification of two products to assess
- Phase two:
- The value assessment of the selected products, including the development of NICE guidance by a Committee convened for the project
- Commercial discussion on the selected products informed by the NICE guidance
- Implementation of payments
- Monitoring the use of the selected products
- Throughout the project:
- Evaluation of the project
- Communication of the project and ongoing learning
– programme launch statement
This approach has parallels with the deal struck in the US between Louisiana and Gilead for access on this basis to Hep. C drugs, where there are similar concerns that tying cost to volume may not result in the best public health outcomes.
The announcement builds on the Government’s ‘Tackling Antimicrobial Resistance 2019-2024: the UK’s five-year national action plan’ which was published at the beginning of the year and is to implemented as part of the NHS Long Term Plan.
The news follows some incremental funding announcements from the Government over the last year, including £30m announced in May for the Global AMR Innovation Fund, and additional UK funding commitments made by the Government in June.