Companies producing antibiotics should invert the traditional pharma business model. Antibiotic manufacturers’ main incentive should be to sell the least amount of antibiotics possible, Shionogi Europe CEO Huw Tippett said at the European Health Summit in Brussels.
A study published in The Lancet in 2024 noted that in people five years and older, antimicrobial resistance (AMR) mortality increased from 1990 to 2021 in all regions except for western and central Europe.
Globally, 1.14 million deaths were attributable to bacterial AMR in 2021.
This figure is set to rise to 1.91 million every year by 2050, with the number of deaths associated with AMR being even higher at 8.22 million.
The final panel discussion of the 2024 European Health Summit held at the Egmont Palace, Brussels, focused on the challenge of fighting AMR, including the dilemmas pharmaceutical companies face.
“With most pharmaceuticals, you get reimbursed for every pill that you sell. With antibiotics, you want to conserve them. We want to make sure they’re only being used in certain instances for the right patient at the right time. So actually, the normal model doesn’t work that well,” Tippett said during the discussion.
Tippett said a sustainable market is needed that brings more investors and more companies into the antibiotics space. Promising business models were also starting to emerge.
Subscription model based on value, not sales
In the UK, Shionogi ran a pilot where their revenue was delinked from the sales of one of their antibiotics. Rather than turning a profit based on sales, the subscription model paid Shionogi a fixed sum based on a health technology assessment of their value to the NHS.
“The pilots run very well, and now that’s moving into a full model in the UK,” said Tippett.
Carlos Montañés, CEO of pharma company HIPRA, said more money is needed to incentivise companies to develop antibiotics to overcome the relatively small market size and cumbersome regulations. He added that models that simply reimburse companies money for what they have spent are not incentivising.
“So one of the things that has really worked is, and [the Health Emergency Preparedness and Response (HERA) department] has done a terrific job with this, is advanced purchase agreements,” Montañés. “This is securing market sales for companies that are developing a product that potentially will not have a lot of sales, but if we have that safety net, then we will go for this.”
G20&G7 Health and Development Partnerships Executive Director Hatice Beton said that many antibiotic developers around the world go on to develop these drugs because they are driven by their ethical commitments and standards, “knowing that they will not be millionaires.”
Developing a new antibiotic costs around $1 billion and will likely make the company that created it less than $100 million a year once on the market.
Despite these figures, Montañés said he refuses to believe there isn’t the necessary money in Europe to address AMR, especially in light of the high number of deaths it’s causing.
AMR as a social justice issue
Professor Dame Sally Davies, the UK Special Envoy on Antimicrobial Resistance, delivered closing remarks on the first day of the summit, where she sought to raise awareness among the audience about how ubiquitous AMR is, even among their own family and friends.
Davies also highlighted that one in four cancer patients is battling a serious infection – while the cancer medication may be working, many of the infections are untreatable and will eventually kill them.
“It is a matter of social justice. A matter of inequality. The burden generally falls on the most vulnerable. Part the children and the elderly,” she said.
Olivér Várhelyi, the European Commissioner for Health and Animal Welfare, also addressed the summit, describing AMR as one of Europe’s biggest health threats.
“We need to address under-investment and create a market for new and more effective antibiotics, developed and manufactured in Europe,” he said.
Market access
Asked about what the European Commission was doing to improve access to antibiotics, Head of HERA Laurent Muschel said it isn’t only low-and middle-income countries that are struggling with access but that this is also an issue within the EU.
“That’s why we just signed actually today an award decision for specific antibiotics to be available in smaller member states, which have difficulty to access the market because the companies have no interest to do packaging for small quantities,” Muschel said.
The €40 million contract was awarded to Italian pharmaceutical company Menarini as a pull incentive pilot to provide a specific antibiotic to any hospital in the participating 21 EU member states within 48 hours.
“The measure of success is to make sure the hospitals that need this type of antibiotic will get access. And they are not getting access until now,” Muschel told Euractiv on the sidelines of the summit.
[ Edited by Brian Maguire | Euractiv’s Advocacy Lab ]
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Publish date : 2024-12-05 20:35:00
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