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Erschienen in: Applied Health Economics and Health Policy 1/2017

01.02.2017 | Short Communication

Promoting Antibacterial Drug Development: Select Policies and Challenges

verfasst von: Aylin Sertkaya, Amber Jessup, Hui-Hsing Wong

Erschienen in: Applied Health Economics and Health Policy | Ausgabe 1/2017

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Abstract

Background

The development pipeline for antibacterial drugs has not met the demand of hospitals and healthcare providers struggling to cope with increasing problems of antibacterial resistance. Although the challenges associated with antibacterial drug development have been known for some time, previous efforts to address them have not been sufficient. There remains an urgent need for targeted incentives to foster antibacterial drug development while encouraging prudent use.

Objective

We examine the effects of two types of incentives, a 5-year delay in competition from generics and a lump-sum US$50 million prize payment upon successful US Food and Drug Administration approval, on antibacterial drug company returns.

Methods

We use the decision-tree framework developed in a study for the US Department of Health and Human Services, which models the drug company’s decision process as a revenue maximizer under uncertainty.

Results

Our results show that, to maximize societal benefit, such incentives need to take into consideration the indication(s) the new antibacterial drug is designed to treat as well as the drug development stage.

Conclusions

Optimal policies should maximize the difference between societal benefit, primarily measured as the reduction in public health burden from the development of a new antibacterial drug that treats an infectious disease while ensuring prudent use, and social cost. Here, we show that the two types of policies examined under-incentivize early-stage developers (i.e., do not achieve the desired outcome) and over-incentivize late-stage developers (i.e., achieve the desired outcome but at a cost that is higher than needed) ceteris paribus.
Fußnoten
1
The modeled incentive corresponds to Section 805 of the Generating Antibiotic Incentives Now Act, signed into law as part of the Food and Drug Administration Safety and Innovation Act, which extends the Hatch Waxman provisions related to data exclusivity by 5 years for a Qualified Infectious Disease Product [11].
 
2
On 18 September 2014, the White House issued a series of new actions designed to incentivize efforts to combat antibiotic-resistant bacteria. One of these actions included the launch of a US$20 million prize “… sponsored by the National Institutes of Health (NIH) and the Biomedical Advanced Research and Development Authority (BARDA) to facilitate the development of a rapid diagnostic test to be used by health care providers to identify highly resistant bacterial infections at the point of patient care” [12]. The choice of US$50 million for the case study presented in the paper was loosely based on this US$20 million amount. We assumed that for antibacterial drugs, a lump-sum prize that is 2.5 times that for a rapid diagnostic test might be more appropriate.
 
3
A supplementary protection certificate is a type of incentive used in the European Union as well as Iceland, Liechtenstein, and Norway, which extends the patent life for specific pharmaceutical and plant protection products when granted.
 
Literatur
3.
Zurück zum Zitat Harbarth S, Theuretzbacher U, Hackett J. Antibiotic research and development: business as usual? J Antimicrob Chemother. 2015;70:1604–7.CrossRefPubMed Harbarth S, Theuretzbacher U, Hackett J. Antibiotic research and development: business as usual? J Antimicrob Chemother. 2015;70:1604–7.CrossRefPubMed
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Zurück zum Zitat Kesselheim AS, Outterson K. Fighting antibiotic resistance: marrying new financial incentives to meeting public health goals. Health Aff (Millwood). 2010;29:1689–96.CrossRef Kesselheim AS, Outterson K. Fighting antibiotic resistance: marrying new financial incentives to meeting public health goals. Health Aff (Millwood). 2010;29:1689–96.CrossRef
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Zurück zum Zitat Hwang T, Carpenter D, Kesselheim AS. Paying for innovation: reimbursement incentives for antibiotics. Sci Transl Med. 2015;7:276fs9. Hwang T, Carpenter D, Kesselheim AS. Paying for innovation: reimbursement incentives for antibiotics. Sci Transl Med. 2015;7:276fs9.
7.
Zurück zum Zitat Outterson K, Powers J, Daniel G, McClellan M. Repairing the broken market for antibiotic innovation. Health Aff (Millwood). 2015;34:277–85.CrossRef Outterson K, Powers J, Daniel G, McClellan M. Repairing the broken market for antibiotic innovation. Health Aff (Millwood). 2015;34:277–85.CrossRef
11.
Zurück zum Zitat Food and Drug Administration Safety and Innovation Act of 2012, Pub. L. No. 112-144, 126 Stat. 993 (2012 Jul 9). Food and Drug Administration Safety and Innovation Act of 2012, Pub. L. No. 112-144, 126 Stat. 993 (2012 Jul 9).
Metadaten
Titel
Promoting Antibacterial Drug Development: Select Policies and Challenges
verfasst von
Aylin Sertkaya
Amber Jessup
Hui-Hsing Wong
Publikationsdatum
01.02.2017
Verlag
Springer International Publishing
Erschienen in
Applied Health Economics and Health Policy / Ausgabe 1/2017
Print ISSN: 1175-5652
Elektronische ISSN: 1179-1896
DOI
https://doi.org/10.1007/s40258-016-0279-5

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