The idea was outlined in a Declaration on Combating Antimicrobial signed by 85 drug companies and industry associations that was launched at the World Economic Forum (WEF) meeting in Davos, Switzerland this week.
The plan calls for “Governments to commit funding and support the development and implementation of transformational commercial models that enhance conservation of new and existing antibiotics, while improving financial and access-related predictability for both industry and health systems."
What this means in practice is yet to be decided. One idea is that Governments commit to buy antibiotics in a way that guarantees drug firms a lump sum, which they say will decouple R&D investment from revenue generation.
“Possible approaches include the system of lump sum Market Entry Rewards proposed by the Review on AMR, insurance-like purchase models, and novel intellectual property-based approaches with appropriate safeguards. An integral part of these models is a reduced need for promotional activity from companies.”
Business model
Last year Nobel Prize-winning chemist Venki Ramakrishnan told drug industry delegates at Davos that their reliance on profits to fund R&D was a “terrible business model” when it comes to antibiotic development.
Jeremy Knox from the Wellcome Trust, which supported the new Declaration, agreed that antibiotic development is a problem for the pharmaceutical industry.
“The need to ensure careful stewardship of new antibiotics, as well as a number of other confounding factors, mean that antibiotics have become an area of business that is highly commercially challenged.
“Efforts are clearly needed to rectify this” Know continued, comparing the Declaration to initiatives like the World Health Organization’s (WHO) Global Action Plan and the ‘Berlin Declaration’ by G7 health ministers last year.
Antibiotic conservation
The signatories also call for implementation of the WHO action plan, particularly in relation to the conservation and appropriate use of existing antibiotics.
To achieve this, the drugmakers would also like Government support for diagnostics development.
“We call for improved reimbursement and use of advanced diagnostics. Furthermore, we call for governments, insurers, healthcare providers and other health system stewards to remove financial incentives for individuals or institutions that reward the prescribing of antibiotics in greater volumes.”
For Industry not patients
The Declaration, which specifies that signatories can remove their endorsement at any time, attracted criticism from some groups concerned about the emphasis on bulk purchasing.
Tim Reed, executive director of Health Action International, told us that: “Any initiative which involves pre-purchase agreements is likely to favour the interests of industry rather than the patient. No doubt the pharmaceutical industry will set its own price, be completely opaque about the R&D costs, and cling to their patent status to stifle price negotiation.
He added that: “There are many mechanisms that will encourage innovation and, at the same time, de-link the cost of R&D from the price of the medicine and these are not mentioned” citing a declaration developed by HAI and follow civil society organisations as an example.