UK should pay $25 million for 'Netflix' antibiotic subscription

An expert has said the UK must pay upwards of $25 million per year to drug companies developing new antibiotics under its soon-to-be announced "Netflix" subscription model, which aims to give an incentive for big pharma to develop treatments for drug resistant superbugs.

Despite the best efforts of the UK government to warn against the perils of drug-resistant bacteria, big pharma has almost stopped antibiotic drug development, with precious little progress made on new compounds in the last few decades.

Health secretary Matt Hancock announced the plan at the World Economic Forum in Davos back in January, and the FT Global Pharmaceutical and Biotechnology Conference in London heard that details of a pilot programme are soon to be announced.

Hancock suggested de-linking payments made to companies from the volumes sold to basing payment on a NICE-led assessment of their value.

Kevin Outterson, an expert on business models for antibiotic development and use from Boston University urged NICE to ensure the Netflix-style “subscription” payments for new antibiotics are attractive to pharma.

Also an executive director of the university’s antibiotic R&D investment arm CARB-X, Outterson said that after a series of antibiotic biotechs going bankrupt due to lack of funding, big pharma must take a leadership role in antibiotic development.

But Johnson & Johnson, Sanofi, Pfizer, AstraZeneca, and Novartis are among those cutting back on antibiotic development despite the dire warnings of an impending superbug apocalypse as resistant strains begin to emerge.

Companies including Pfizer are rumoured to be in the frame to provide the drugs that could be included in the pilot programme from NICE and Outterson settled on a figure of $25 million per year as a suitable payment for each drug included in the scheme.

The drugs would only be used as a last resort, and perhaps not at all by some hospitals with effective infection control, Outterson said following a question from the audience.

Kevin Outterson

He said at the conference: “[The government] is close to announcing which two drugs are in the pilot. It holds hope because the pilot is not a traditional NICE assessment.

“I want a reasonable number that is proportional to the UK’s size in the pharma economy. It will be the first example that is not on a pay per pill basis.

“It needs to something north of $25 million per year for access for the rest of its patent life, even if the UK uses little of it."

Using the example of fire safety equipment, Outterson pointed out that new antibiotics should be seen as a last resort in hospitals in the case of serious infections.

“The optimal number of fires in this room is zero but there is fancy equipment in the ceiling to prevent fires -  but you wouldn’t make the people who install that wait until there is a fire before they get a pay cheque.”

One alternative model mentioned during the panel debate was a state-funded drug company, something that was discussed and rejected at the event yesterday during a separate discussion by Labour peer Lord Drayson.

Outterson said this should only be considered after all other models had failed to produce results, saying that the bureaucracy of a state-funded pharma would stifle development.

He noted that this was one suggestion in Lord O’Neill’s landmark report on antibiotic R&D, but suggested it had been included to produce a response from big pharma.

“I would suggest that he (O’Neill) was being a gadfly to get companies to produce a response. It would be a last ditch effort in my mind, I would try everything else first.”