For the last six months I have
been diligently working to establish an international conference on antibiotic
pricing and reimbursement strategies. And I obviously need help. The conference
would be a meeting with payers – that is large insurers like Aetna, United
Health Care and Kaiser in the US and with national authorities in Europe and in
Asia. The main goal of the conference
would to provide payers with an understanding of what kind of data they would
have from feasible antibiotic trials targeting resistant pathogens (LPAD-like
drugs) and the kinds of data that might be available outside such trials. The payers would then respond as to their needs for providing the kinds of
reimbursements that would be required to provide a return on the investment of
pharmaceutical companies in such products within the context of feasibility. Various payment models would be
discussed (see my last blog).
To organize this conference, I have
been in contact with the Pew, The Center for Disease Dynamics and Economic
Policy, the IMI (indirectly), and with a number of pharmaceutical
companies. I have discussed the project
with some South African authorities. I
have approached friends, colleagues and consultants. While everyone has been helpful on their own
individual level, the conference is going nowhere. Among my pharmaceutical
company contacts, among the 250 things on their desks, this idea has a priority
somewhere between 249 and 250. I have been unable to make contact with any
insurers or national health authorities. And as yet I have no commitment for
funding – understandably since I don’t have key participants lined up yet.
I think there are several factors
working against this idea. The main one
being that no one with money (payers) wants to discuss spending it in a public
forum. Making commitments publicly probably scares them. Antibiotic stewardship
is OK. Discussing antibiotics for growth
promotion or prophylaxis in animals is OK (not that we in the US want to do
that either). Discussing using anti-influenza drugs for flu rather than
antibiotics is OK. But there is no getting around the fact that we will and do
now need new antibiotics active against resistant pathogens. And there is no
way for us to have those antibiotics other than investing.
Another factor working against
this concept is the multitude of task forces working around the idea – nibbling
at its edges. There is the Transatlantic Task Force on Antibiotic Resistance
(TATFAR), the President’s Council of Scientific Advisors whose report is
imminent (PCAST) and the new
task force put into place by David Cameron. Of these only the UK group
established by Cameron is likely to broach payers – but they have a very EU
focus. These efforts, in my view, distract us from the goal in many ways. We need implementation
of existing ideas or a discussion that leads to implementation of new
ideas. The key word here is implementation.
I don’t think we need new task
forces or think tanks. I think we need
to get payers to understand what is at stake and to get them to become
stakeholders in this struggle. If anyone can help get this done – either do it
yourself or let me know what I can do.
But right now, I’m at a standstill. Just email me directly or through my LinkedIn
account.
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