England, United Kingdom
#00288
Implements
#00391 Delink antibiotic revenue from sales volume through subscription payments
Implementer
NHS England and the National Institute for Health and Care Excellence
Location
Description
NHS England and NICE piloted fixed annual payments for access to cefiderocol and ceftazidime-avibactam, with value assessment designed to recognize preparedness and public-health benefits rather than prescription volume. The pilot contracts began in 2022 and informed a broader antimicrobial-products subscription model.
The model is ongoing. It has demonstrated that a public purchaser can operationalize delinked payment, but evidence is not yet sufficient to conclude that it has increased global antibiotic innovation, improved access outside England or produced better patient outcomes.
Metrics
1Lessons learned
- A subscription contract can remove the direct incentive to maximize antibiotic sales.
- Contracts need supply, stewardship, surveillance and access obligations in addition to fixed payment.
- Evaluation should track pipeline investment, product availability and patient outcomes, not only successful procurement.
Sources
2