Presentation (CTI)

OBJECTIVES: Decision-makers globally are implementing reimbursement incentives for antimicrobial development to address the increasingly urgent threat of antimicrobial resistance (AMR). Building on previous research outlining AMR policies and funding schemes, and establishing the United Kingdom (UK) and Sweden as forerunners in AMR incentive development, our objective was to analyse the learnings from their respective reviews of the pilot programmes.
METHODS: A keyword search and review of health agency websites in the UK and Sweden was conducted to extract the key incentive characteristics (e.g., eligibility, timeframe, funding). Reports from each organisation were used to pull information on key pilot strengths and limitations into a table matrix to facilitate comparison. Information was synthesised to draw insights potentially applicable to other countries/future incentives.
RESULTS: Both schemes are volume-delinked ‘pull-incentives’. In Sweden, manufacturers receive a guaranteed minimum income plus 10% inventory incentive. In England, manufacturers receive a fixed annual fee (range: £5-20 million; eligibility score-dependent). Similar learnings from both pilots included agreement to focus on antimicrobials targeting the WHO pathogen priority list. Both pilots highlighted the need for incentive flexibility over time including the possibility of new/updated eligibility assessment and procurements to reflect the evolving AMR landscape and clinical needs. A limitation in the UK was the pilot’s complexity and resource-intensiveness for both manufacturers and agency. In Sweden, the volume requirements leading to stock exceeding medical need and resulting wastage was an issue later adjusted so stock is adapted to previous sales.
CONCLUSIONS: Learnings from both countries underscore the need to establish and refine antimicrobial procurement processes. Ongoing dialogue between stakeholders is vital based on the complexity and novelty of such evaluations. Nations and healthcare systems must consider their contribution to the global AMR effort when developing their incentives. Future consultation with manufacturers would determine the impact of incentives on antimicrobial investment.