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The deal, initially for two antimicrobial drugs, means patients with serious infections that have evolved so much that antibiotics and other current treatments are no longer effective, can be given a potentially life-saving alternative.
These drugs will provide a lifeline to patients with life-threatening infections like sepsis, hospital or ventilator pneumonia and blood stream infection, with increasing numbers of people developing drug resistance as germs evolve to become resistant to current antibiotics.
A study from the University of Oxford published this year estimates that around 1.2 million deaths globally were caused by antibiotic resistance and experts predict this will only grow.
This first-of-its-kind NHS scheme means pharmaceutical firms will receive a fixed yearly fee – capped at a level that represents value to taxpayers – in order to incentivise funding for innovation that can generate a pipeline of new antibiotics for NHS patients.
Around 1,700 patients per year with severe bacterial infections will be eligible for the drugs, called cefiderocol and ceftazidime–avibactam, manufactured by Shionogi and Pfizer respectively.
This new style of agreement with the drug manufacturers will ensure they work in partnership with the NHS to protect their longevity, using them when necessary but preserving their effectiveness for future years.
Announcing the deal at NHS ConfedExpo, NHS Chief Executive Amanda Pritchard called the revolutionary subscription deal a game-changer and the latest NHS success in using its commercial power to benefit NHS patients in line with the NHS Long Term Plan.
NHS Chief Executive Amanda Pritchard, said: “Superbug-busting drugs on the NHS will save lives and strike a blow in the global battle against antimicrobial resistance.
“Until now, innovation in antibiotics has been limited, but this pioneering NHS subscription scheme aims to turn the tide by working with pharmaceutical firms to make sure we have these superbug-battling drugs ready and available to those patients who need them most.
“This world-leading agreement not only provides a template for other countries to follow, incentivising antimicrobial drug innovation globally, as we collectively deal with this threat to modern medicine and public health, but also gives new hope to thousands of patients who previously had no treatment options left.
“We have shown through the course of the COVID-19 pandemic the power of working together, combining our expertise across industries, in order to tackle emerging risks – whether that is COVID-19 or the very real threat of antimicrobial resistance – head on”.
This revolutionary deal meets a key commitment set out in the NHS Long Term Plan and has been developed as a result of a UK-wide project between NHS England, NICE and DHSC.
It is the first time any health system in the world has successfully assessed the value of an antimicrobial in this way and is aimed at incentivising further innovation among drug firms to beat superbugs.
NHS Medical Director, Professor Sir Stephen Powis, said: “This is a huge milestone in the country’s quest to tackle the increasing global threat of antimicrobial resistance and it is fantastic that the NHS has been able to lay down the footprint to tackle this and deliver a revolutionary deal two years ahead of the target set out by Government in 2019.
“Tens of thousands of people suffer from drug-resistant superbugs every single year in England and this deal will offer hope to those who have had limited or no success with current treatments”.
This UK approach to incentivising innovation in antimicrobial drugs to tackle superbugs overcomes the issue of paying pharmaceutical companies based on the number of drugs bought or prescribed, given they will be subject to stricter rules on who is able to receive them in order to ensure they continue to work effectively.
There is a maximum contract value set at a level where payments would represent an incentive for investment should other countries pay similar sums, up to a maximum of £10 million a year for up to 10 years.
NHS Commercial Medicines Director, Blake Dark, said: “Once again the NHS is showing international leadership in using our commercial capabilities to reshape the approach to healthcare challenges, as we have done with hepatitis C infections, with early cancer testing and cardiovascular treatments.
“Working closely with partners at NICE and with Shionogi and Pfizer, we know we’ve done something really special here and I’ve been delighted by the number of countries contacting us to ask how they can learn from this revolutionary approach”.
The NHS is committed to adopting the latest cutting-edge treatments as part of the Long Term Plan including by striking deals for world-leading drugs and helping to increase innovation.
In the last year, the NHS has agreed deals for a range of revolutionary drugs, including the world’s most expensive drug to treat Metachromatic Leukodystrophy, the first sickle cell treatment in 20 years, and a number of targeted cancer treatments for the most advanced and aggressive forms of tumour.
Susan Rienow, Managing Director and Country Manager, Pfizer UK said: “We are incredibly proud to be partnering with the NHS, NICE and UK government in piloting this innovative reimbursement model for antimicrobials. This world first initiative is a critical step in tackling one of the biggest threats to global health today and ensuring access and appropriate use of antibiotics for patients in England.
“We look forward to continued partnership on the assessment of the broader value antibiotics bring to people and society and working with our global colleagues to ensure AMR collaboration is a global initiative with local action”.
Mark Hill, SVP, Global Head of Market Access, Shionogi, said: “Shionogi supports the UK’s leadership position with the introduction of the world’s first subscription reimbursement model for antimicrobials. It is hoped that this model will encourage investment in this critical area and promote good stewardship to limit the potential development of antimicrobial resistance. We have worked closely with NHSE to agree a deal to begin reimbursement of our antibiotic, as part of this innovative scheme and look forward to partnering with NHS England”.