U.K. calls for globally organized incentives for antibiotic R&D

Westminster Bridge in London at sunset
Westminster Bridge, London (IakovKalinin)

The U.K. wants the international community to come up with a coordinated system for incentivizing the development of antimicrobials. Government officials floated the idea in a report (PDF) setting out how the U.K. plans to tackle the threat posed by drug-resistant bacteria over the next five years.

In recent years, the U.K. has tried to establish itself at the forefront of global efforts to address the problem of antimicrobial resistance (AMR) through activities including an earlier five-year strategy and the commissioning of an independent review. Now, the U.K. has set out its hopes for the next five and 20 years in a bid to continue advancing global action against AMR.

The five-year plan features a section about the development of new therapeutics. In light of the long wait for a new class of antibiotics and factors that discourage use of new products, the U.K. wants to encourage renewed interest in the field by offering incentives to drug developers. 

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As a relatively small country facing a global problem, the U.K.’s ability to move the needle through independent actions is limited. The government therefore plans to “work with international partners to agree a coordinated global system for incentivising new therapeutics.” The U.K. is yet to say how it thinks drug developers should be incentivized but has built up a portfolio of ideas in recent years.

In 2016, the U.K. government voiced strong support for the “global system of market entry rewards” proposed by the independent AMR review. The government referred to that suggestion in a recent submission (PDF) to a parliamentary committee, citing the review’s lump sum and “pay or play” proposals.

The two proposals serve as a carrot and stick, respectively. For the carrot, the authors of the review proposed paying up to $1.5 billion to companies that bring new antimicrobials to market. On the other hand, the review proposed making pharma companies pay a surcharge if they choose not to invest in antibiotic R&D.

For now, these are just ideas. But the texts published this week show they remain on the minds of U.K. officials tasked with tackling AMR. With the G20 group of big countries committed to exploring “practical market incentive options,” the U.K. has a potentially receptive audience for the ideas, too. 

The focus on incentives to antibiotic R&D is predicated on the assumption that the lack of new drugs stems, at least in part, from the absence of a business case. Market forces are likely a factor, but any explanation of the dearth of new antibiotics must account for the fact that some well-resourced R&D groups tried for years to make advances without success. 

In 2007, GlaxoSmithKline documented its multiyear effort to use the sequencing of a complete bacterial genome in 1995 to usher in an era of genomics-enabled antibiotic advances. The hoped-for breakthroughs never materialized, though, prompting companies to again pull back from the field. 

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