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Aligning industry incentives with AMR control goals: Exploring the feasibility of an antibiotic susceptibility bonus for drugs to treat Gram-negative infection

English title Aligning industry incentives with AMR control goals: Exploring the feasibility of an antibiotic susceptibility bonus for drugs to treat Gram-negative infection
Applicant Harbarth Stephan Jürgen
Number 180205
Funding scheme Joint Programming Initiative on Antimicrobial Resistance (JPIAMR)
Research institution Infection Control Program Hôpitaux Universitaires de Genève Faculté de Médecine, Université de Genève
Institution of higher education University of Geneva - GE
Main discipline Economics
Start/End 01.02.2018 - 31.01.2020
Approved amount 202'959.00
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All Disciplines (2)

Discipline
Economics
Medical Microbiology

Keywords (9)

sustainable use of antibiotics; antibiotic efficacy; antimicrobial resistance; health economics; financial incentive; antibiotic conservation; infection prevention; antibiotics; Gram-negative infection

Lay Summary (French)

Lead
Antibiotic Susceptibility Bonus
Lay summary

Actuellement la promotion et la vente des antibiotiques à grande échelle représentent une incitation perverse qui entrave la lutte contre la résistance antimicrobienne.  En effet ce désaccord entre la poursuite des ventes maximales et les intérêts publics de la santé est extrêmement inquiétant et nous pousse à chercher de nouvelles façons de structurer ce marché – un nouveau modèle commercial. Ce projet explore la viabilité d’une prime, offerte plusieurs années après la mise en marché de l’antibiotique – par exemple tous les cinq ou dix ans – si l’antibiotique reste suffisamment efficace. En offrant une prime plus intéressante que les ventes, si souvent incertaines, le ‘Antibiotic Susceptibility Bonus’ pourrait a priori inciter l’industrie à soutenir les efforts de conservation des antibiotiques ainsi que la prévention et le contrôle de l’infection – et ainsi de cesser les activités de marketing et de promotion de l’antibiotique au but de profit uniquement. Si un tel régime est estimé comme étant viable, il pourrait aider à aligner les intérêts industriels avec la santé publique au fil du temps pour protéger cette ressource médicale si précieuse.

Direct link to Lay Summary Last update: 11.12.2017

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Abstract

Sales of antibiotics are often independent of actual need. From the perspective of public health the maximisation of antibiotic sales represents a major perverse incentive in that it goes directly against the need to preserve antibiotic efficacy. This multidisciplinary study explores the feasibility of a finance-based intervention intended to directly re-align pharmaceutical industry interests with the minimization of antibiotic resistance and with the overall prolongation of antibiotic efficacy. By rewarding pharmaceutical companies through bonus payments for protecting their product over time through an Antibiotic Susceptibility Bonus this intervention helps reinforce efforts towards good prescribing practice and towards minimizing the risk of acquisition, development and transmission of antibiotic-resistant bacteria. The lure of a bonus greater than expected revenues from unit sales will help align efforts behind comprehensive infection prevention and control efforts in all settings, including hospitals and communities, as well as across agriculture and the environment. Indeed all public and private AMR initiatives across One Health sectors could be bolstered. This project explores the feasibility of the Antibiotic Susceptibility Bonus. If it is deemed to be feasible the work will establish the susceptibility sampling and aggregation framework, calculate appropriate bonus magnitudes based on market considerations, and apply the overall work two relevant antibiotic cases.
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