Taking Collective Action
We support the increasing recognition that the value assigned to antibiotics and diagnostics often does not reflect the benefits they bring to society, nor the investment required for their creation. Therefore, we call on governments to commit to allocating the funds needed to create a sustainable and predictable market for these technologies while also implementing the measures needed to safeguard the effectiveness of antibiotics. Specifically:
Creating a sustainable and predictable market. We call for governments to commit funding and support the development and implementation of transformational commercial models that (a) enhance conservation of new and existing antibiotics, while (b) improving financial and access-related predictability for both industry and health systems.
Enhancing Conservation
We support measures for the prevention of infection along with conservation and appropriate use of all antibiotics, including:
In January 2016, the life-sciences industry signed a Declaration on Combatting Antimicrobial Resistance at the World Economic Forum,
Followed by a Roadmap of several big pharma at the UN High-Level Meeting in September 2016 – a common framework of principles for global measures to curb the development of antibiotic resistance.
The “AMR Industry Alliance”, launched in May 2017, now links these two initiatives together and ensures that the signatories collectively deliver on the commitments made.
Enhancing Conservation
Improving financial and access-related predictability for both Industry and health systems is required to ensure sustainable investment in new antibiotics and diagnostics. To this end, we welcome appropriate incentives, coupled with safeguards to sustain the effectiveness of new and existing antibiotics. We believe two fundamental approaches are needed to accomplish these goals:
We welcome proposals that (a) support reduction in the link between financial revenues for new antibiotics and the amount they get used while (b) mitigating the financial risk for both developers and health systems. As different jurisdictions may require different solutions, a range of approaches to creating such delinkage will likely need to be utilised. Possible approaches include the system of lump sum Market Entry Rewards proposed by the Review on AMR, insurance-like purchase models, and novel intellectual property-based approaches with appropriate safeguards. An integral part of these models is a reduced need for promotional activity from companies.
We also support the principle that in developed markets, prompt reimbursement decisions at prices that reflect value should be provided for new drugs and diagnostics to reflect the benefits they bring (with measures for stewardship to prevent misuse) – as also acknowledged in the work of the Review on AMR. This calls for funding to be allocated and for payers to appropriately assess and value innovative antibiotics and diagnostics, in line with the good progress that has been made by regulatory authorities.
Global coordination, local action.
We call for a global commitment to coordinated action on stewardship, conservation, hygiene, and the creation and use of new commercial models for antibiotics and diagnostics. As noted above, we recognise different models may be appropriate for different countries, health systems, and products. All parties should commit to allocating funding and finding paths that work for their situation. We are ready to work stepwise with countries to implement such models.