Background

Antimicrobial resistance is a growing global healthcare priority that requires continuous development of new antimicrobials. However, innovation and development of new antimicrobials continues to be a challenge and multiple companies have disinvested from this area. This study aimed to understand the differences in observed willingness to pay by healthcare systems between anti-bacterials and other non-antibiotic curative therapies reimbursed in the UK, by analysing the cost of treatment to achieve a cure , across different therapeutic areas.

Method

The list of newly approved medicines was obtained from the European Medicines Agency up to March 2020 and evaluated as curative or non-curative, for each of their approved indications. Generics, biossimilars, preventive and chronic treatments not leading to potential cure/eradication, were excluded. For each drug/indication, the cost of treatment to achieve a cure was calculated using the prescribing information, national published price lists, and weighted by the cure rates achieved for each drug/indication as per the endpoints defined in pivotal trials. The cost per cure was then analysed per therapeutic area.

Results

42 curative treatments were identified, predominantly in hemato-oncology and anti-infectives. The cost/cure was substantially higher for oncology treatments (n=20; mean: £286,910/cure; range: £57,871–£698,019), followed by treatments for hepatitis C (n=7; mean: £35,457/cure; range: £26,800-£41,031); tuberculosis (n=2; mean: 45,763€/cure; range: £19,977-£32,758) and antibacterials (n=17; mean: £3,106/cure; range: £646 - £7,393).

Conclusion

Despite the multiple limitations of this research (use of published list prices, different definitions of cure, different burden for the healthcare system, unmet need and populations affected by each condition, it highlights inconsistencies in the willingness to pay for curative treatments in different therapeutic areas. It is particularly low for antibacterials, which could contribute to the low investment in R&D in this therapy area. Further research is required to better understand the reasons and implications of such findings.