A new report from the Council of Canadian Academies (CCA) says a subscription pull incentive (SPI) is needed to provide the country with a more stable supply of novel antibiotics.
The report by an expert panel concludes that, of the pull incentives that have been proposed to boost antibiotic research and development (R&D), which is hampered by low sales and poor return on investment, an SPI holds the greatest promise for revitalizing Canada's antibiotic market. The report notes that Canada lags behind peer countries in access to novel antibiotics; of the 18 antibiotics that have been approved since 2010, only 3 are commercially available.
An SPI could boost access to antimicrobials that already exist but are not currently approved or available in Canada.
If Canada were to work with other countries and contribute to a global SPI mechanism, the experts estimate that fair contribution from the Canadian government would be in the range of $14.5 to $18 million (Canadian) per drug per year over 10 years, with payment levels varying based on drug value.
"An SPI could boost access to antimicrobials that already exist but are not currently approved or available in Canada," the panel wrote. "It could also motivate research, development, and commercialization of new drugs."
Incentivizing antibiotic R&D
The subscription model is similar to one in the United Kingdom, where the National Health Service is paying yearly subscription contracts for guaranteed access to two critically needed antibiotics, and to legislation (the PASTEUR Act) under consideration by US lawmakers. The idea behind subscription pull incentives is that paying for new, innovative antibiotics based on their public health value rather than sales volume will provide a stable return on investment for drugmakers and incentivize antibiotic R&D.
"The development of antimicrobials changed the face of medicine, but the numerous benefits they provide to individuals, healthcare systems, and society are increasingly under threat," CCA President and CEO Eric M. Meslin, PhD, said in a news release. "This report details an approach that would maintain these myriad benefits by finding new mechanisms to motivate the development and commercialization of novel antimicrobials."