The UK commits to a delinked antibiotic purchase model!

Dear All:

Wow! It’s happened! As reported this morning in The Times and The Guardian among others, the UK will announce at Davos that it is committing to a 20-year vision and initial 5-year plan to combat AMR. The plan includes actions to reduce infection rates, to reduce antibiotic use, and most importantly for this audience to find a path to delinked antibiotic purchases.

The key documents are here

• The 20-year vision
• The initial 5-year national action plan

The 20-year vision lays out these 9 ambitions:

1. Continue to be a good global partner
2. Drive innovation
3. Minimise infection
4. Provide safe and effective care to all patients
5. Protect animal health and welfare
6. Minimise environmental spread
7. Support sustainable supply and access
8. Demonstrate appropriate use of antimicrobials
9. Engage the public on AMR

The idea of pursuing a delinked (read more here and here about the background on this idea) purchase model seems to span several of these objectives and is stated on the web page that introduces the report as well as in the Forward to the 5-year plan: “We will test a new model that will de-link the payments made to companies from the volumes of antibiotics sold, basing the payment on a NICE led assessment of the value of the medicines and supporting good stewardship.” and then again in Section 4.3.1 of the 5-year plan as a specific goal: “Develop and test new models for national purchasing arrangements that de-link the price paid for antimicrobials from the volumes sold, using a NICE led healthcare technology assessment to support robust stewardship.”

The news reports suggest a 6-month timeline on this process, but I don’t find that specifically discussed in the National Action Plan.

This is so VERY good to see! That we have arrived at this exciting step is due to the work of the many, many hands behind DRIVE-AB, the O’Neill-led UK AMR Review, the Duke-Margolis-led reviews, and more. There’s of course more work to be done and many questions to resolved (which antibiotics to buy? how much to pay? how to pay? what duration of purchase?), but at least we are at the stepping off point for a new approach to reimbursing antibiotics. I am minded of Mr. Churchill’s famous quote from 1942: “This is not the end. It is not even the beginning of the end. But it is, perhaps, the end of the beginning.”

Fabulous!

All best wishes, –jr

John H. Rex, MD | Chief Medical Officer, F2G Ltd. | Expert-in-Residence, Wellcome Trust. Follow me on Twitter: @JohnRex_NewAbx. See past newsletters and subscribe for the future: https://13.43.35.2/blog/

Upcoming meetings of interest to the AMR community:

• 4-5 Feb 2019 (London): Hamied Foundation UK-India Antimicrobial Resistance Meeting 2019. This is a 2-day meeting focused on building research links between the UK and India with the specific aim of jointly addressing the challenge of AMR. Register here.
• 14-15 Mar 2019 (Berlin): BEAM-, CARB-X-, Novo REPAIR-, DZIF-, ND4BB-ENABLE-sponsored (among a long list!) Berlin Conference on Novel Antimicrobials and AMR Diagnostics. Details here. Poster submissions are being accepted through 9 Jan (details here).
• 21-22 Mar 2019 (Birmingham, UK): BSAC Spring Conference.
• 26 Mar 2019 (London, UK): Sponsored by The Economist, a 1-day symposium entitled “Antimicrobial Resistance: Preventing an antibiotic apocalypse.” Register here.
• [RESCHEDULED] 28 Mar 2018 (REVIVE webinar, 4-5.30p GMT): “Clinical development for non-developers Part 3: Antibacterial Drug Enhancer Combinations and Non-traditional Products.” Register here.
• 13-16 Apr 2019 (Amsterdam): Annual ECCMID meeting
• 16-18 Apr 2019 (Utrecht): ICOHAR, International Conference on One Health Antimicrobial Resistance. Organized by the ESCMID Study Group for Veterinary Microbiology (ESGVM).
• 24-26 Apr 2019 (Boston): Annual SHEA (Soc. for Hospital Epidemiology of America) Spring meeting
• 6-11 May 2019 (Ljubljana, Slovenia): 37th Annual Meeting of the European Society for Paediatric Infectious Diseases (ESPID). Details here.
• 3-6 Jun 2019 (Philadelphia): Annual BIO meeting
• [NEW] 10-11 June 2019 (Research Triangle Park, NC): AMR Action Summit on R&D and Commercialization. Sponsors include the British-American Business Council, the UK Gov’t, CARB-X, the NC Biotechnology Center, and others. Details here.
• 20-24 June 2019 (San Francisco): Annual ASM Microbe meeting.
• [Mark your calendar now!] 3-6 Sep 2019 (Boston). Annual ASM-ESCMID Conference on Antibiotic Development. The Bootcamp series will continue on 3 Sep with the main meeting on 4-6 Sep. Mark your calendar now and check back here for details.
• 6-8 Sep 2019 (Bilbao, Spain): 5th ESCMID conference on Vaccines. Check back here for details.
• 2-6 Oct 2018 (Washington, DC): IDSA’s annual IDWeek meeting.
• 19-27 Oct 2019 (Annecy, France): International Course on Antibiotics and Resistance (ICARe) – A soup-to-nuts intensive residential training program on all things AMR, especially R&D for new antibiotics. See this link for details.