A comment by James Anderson, Head of Corporate Government Affairs at GSK and new Chair of the ABPI Antibiotic Network.
Will we look back at Friday 9 October 2015 as a turning point in efforts to combat antimicrobial resistance? Building on a growing global consensus around the need for improved incentives to invest in R&D for new antibiotics, a clear step forward was taken on that Friday when G7 Health Ministers committed to explore innovative economic models to enhance research and development. In doing so, they demonstrated an appreciation of the critical importance of the antimicrobial resistance (AMR) challenge and applauded the groups working to address it.
Chatham House has been running one such group, which also published an important policy document last Friday. The result of over two years of constructive dialogue involving stakeholders from governments, WHO, NGOs, academic experts and industry, the report proposes a new business model consisting of a range of incentives across the life-cycle. It is designed to encourage investment in antibiotic R&D without also incentivising sales volumes, which could accelerate the development of resistance. The proposed model would deliver a return on investment for antibiotics that is not dependent on the volume of sales. This approach is known as "delinkage".
The delinkage model proposed by Chatham House is consistent with recommendations published earlier this year by the independent AMR Review, which is led by the prominent economist and Commercial Secretary to the Treasury Lord O'Neill. It is also supported by a recent paper from the OECD, which recognises the "intrinsic value" of a new antibiotic arising from its availability rather than its use. Last week's G7 declaration further stressed the need to review the economics of antibiotics R&D, and committed to investigate new financial models, such as a global antibiotic research fund and a market entry reward mechanism for novel antibiotics targeting key pathogens.
Significant challenges need to be overcome before an innovative new model could be implemented. These include the need to decide which types of antibiotics would receive financial rewards, how much those rewards should be, where the funds would come from, and how the resulting products could be simultaneously conserved and made available to all patients who need them globally. The new model is unlikely to have a significant impact on the products we sell today. Work from Chatham House, the O'Neill Review and the on-going the Innovative Medicines Initiative "NewDrugs4BadBugs" programme are starting to provide answers, but there is still a way to go.
Industry has been a strong advocator of the need for a new economic model and has played an important role in exploring different options for the design and implementation of this. This work must continue to be a priority for us. Concepts such as delinkage are complex and are not applicable across all therapy areas, but they may be helpful in solving the specific issues around AMR, where old models have been proven not to work, and where investment is critically lacking. It's encouraging that consensus is growing globally around the need to incentivise research into antibiotics. Redesigning the economic model is a big challenge, but continued constructive engagement by industry will be crucial to ensuring that the new model enables sustainable, long-term development of these life-saving medicines.