David's New Book

Monday, August 4, 2014

Making Antibiotics Attractive - HELP!

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.