Session (CTI)

Issue: Antimicrobial resistance (AMR) represents a critical global health challenge: we urgently need new antibiotics, yet current HTA approaches have become an active barrier to this innovation. The STEDI framework (Spectrum, Transmission, Enablement, Diversity, and Insurance value) emerged as an experiment in methods evolution—designed to capture the full value of antimicrobial products by adopting a "whole health" perspective that extends beyond traditional cost-effectiveness analysis. However, progress toward demonstrating STEDI in practice has stalled, raising essential questions about whether this represents the future of value assessment. Critically, AMR exposes a structural limitation of traditional HTA and reimbursement models: society needs antibiotics even when appropriate stewardship aims to keep their use low. This panel brings together stakeholders from divergent perspectives to debate what STEDI's stalled momentum reveals about the real appetite for broader, holistic measures of value in healthcare decision-making—and whether this experiment can ultimately reshape how we assess antimicrobial innovation. Overview: Research demonstrates that rigorous STEDI quantification remains elusive, with decision-makers resorting to manual adjustments and substantial upward revisions of initial valuations. Meanwhile, the May 2024 UK antimicrobial subscription framework appears to have evolved away from strict STEDI adherence toward more pragmatic criteria-based assessment. Yet international jurisdictions (Spain, Greece, Canada) are cautiously exploring STEDI-inspired approaches despite evidence of substantial uncertainty. An alternative pathway is emerging in Italy, where access to WHO 'Reserve' antibiotics is enabled through a dedicated national fund combined with AIFA monitoring registries—prioritizing access, stewardship and real-world tracking over full STEDI quantification. This session directly addresses the current inflection point in antimicrobial economics policy and will generate essential debate as global health systems finalize their approaches.