NHS steps up battle against life-threatening infections following successful world-first pilot

The NHS has launched plans to expand pioneering subscription-style drug contracts to develop lifesaving antibiotics of the future.

It comes as data shows more people are contracting drug-resistant superbugs than ever before, with antimicrobial resistance (AMR) predicted to cause 10 million global deaths each year by 2050 if no action is taken.

NHS England is building on its world-first pilot to incentivise the pharmaceutical industry to develop new antibiotics that could be offered to NHS patients when they need them the most.

The consultation has launched almost a year to the day that contracts for two superbug-busting drugs were rolled out as part of a world-first pilot.

Cefiderocol and ceftazidime-avibactam, new antibiotics manufactured by Shionogi and Pfizer respectively, were awarded world-first subscription contracts which provided the companies with a fixed annual fee based primarily on the availability of the drugs and their value to the NHS, as opposed to the volumes used.

By breaking the link between the payments companies receive and the number of their antibiotics prescribed, the NHS is removing any incentive to overuse antibiotics, decreasing the risk of life-threatening infections, such as sepsis and pneumonia, becoming resistant to treatment.

Under the proposals, the annual payments for an antibiotic contract could be doubled from £10 million to £20 million, where outstanding clinically based criteria are met, representing exceptional value to patients and taxpayers. The National Institute for Health and Care Excellence (NICE) will determine the value of antimicrobial treatments submitted to the programme using newly designed clinically led award criteria and scoring system, devised by NICE based on the pilot learning.

The 12-week public consultation will seek input from the pharmaceutical industry, patients, carers, and academics. The consultation proposals are to prioritise products that are active against pathogens on the WHO Priority List, which outlines the 12 families of bacteria that pose the greatest threat to human health.

The NHS’ commitment to tackle AMR is shared across governments, international agencies, researchers, and the pharmaceutical industry, recognising the urgency of taking action to ensure future pandemic preparedness.

David Glover, NHS assistant director of medicines analysis, said: “The NHS is proud to be leading the way and using our commercial capabilities to reshape the global approach to the critical healthcare threats posed by antimicrobial resistance.

“As we continue to take lessons from the COVID-19 pandemic, the development of new antibiotics is absolutely essential to help build resilience to respond rapidly to new superbugs and save lives.

“With the proposed expansion of our world-first subscription model following a successful pilot, we want to meet this challenge head on and lead the response to the global battle against antimicrobial resistance, which could undermine the ability to deliver routine hospital care and treatment for patients.”

Nick Crabb, programme director, Scientific Affairs at NICE, said: “NICE is committed to supporting the ambition of the NHS to have access to effective new antimicrobials to call on when needed, and patients aren’t left without treatment options in the face of growing antimicrobial resistance. Today’s announcement shows the UK is leading the way in finding solutions that will ensure the antibiotics market is fit for purpose. Taking on board the learnings from the recent pilot we are now moving to the next stage, embedding routine arrangements for the evaluation and reimbursement of new antimicrobials within the NHS, across all nations of the UK. A new panel convened by NICE will play a critical role by evaluating antimicrobials using a novel and pragmatic, clinically led award criteria and scoring system.

“But the UK can’t face this growing challenge on its own, so we will continue to share our learning with international stakeholders and encouraging other countries to offer similar incentives in their own domestic markets, so that collectively we can achieve a meaningful incentive for global investment in antimicrobials.”

Richard Torbett, ABPI Chief Executive said: “AMR is a global issue that requires urgent attention, and the UK is leading this fight by developing a pragmatic new approach to help secure the antibiotics the world needs. Demonstrating and delivering a successful UK contribution to this global challenge is critical to encourage other healthcare systems to develop the complementary solutions necessary to find a lasting solution to this challenge.”