Why the emergence of a Netflix-style medicine subscription model is stirring curiosity

Pharma News: Promising initiatives aimed at attracting pharmaceutical companies away from volume-based sales and incentivising research into urgently needed new treatments are gaining momentum. A new report has warned a global crisis of antibiotic resistance is inevitable, despite promising developments in new antibiotics.

At the forefront of the battle against superbugs, the University of Queensland’s Institute for Molecular Bioscience (IMB) Centre for Superbug Solutions has been diligently monitoring the clinical pipeline for over a decade. Their latest findings reveal that 62 new antibiotics are currently in various stages of development.

“We’re making progress,” said Professor Mark Blaskovich, Director of Translation at the IMB. “Encouragingly, 34 of these new antibiotics are based on structures never before used as antibiotics. This means that the resulting medications will be less likely to face existing resistance in bacteria, potentially buying us more time before resistance develops.”

However, Professor Blaskovich cautioned that the glass is only half full. While the developments are promising, the number of new antibiotics pales in comparison to other classes of drugs. For example, the cancer drug pipeline boasts nearly 2,000 potential candidates. With the urgency of the antibiotic resistance crisis, there is still much ground to cover.

Antibiotic-resistant infections continue to take lives globally, with a staggering 1.27 million deaths directly attributed to resistant bacteria in 2019. Additionally, a further 4.9 million deaths were associated with drug-resistant infections. The situation is dire, and swift action is imperative.

In response to the pressing need for more antibiotics, various funding initiatives have emerged, including the Combating Antibiotic-Resistant Bacteria Biopharmaceutical Accelerator (CARB-X). These efforts have shown early promise, leading to almost twice as many candidates reaching the first stage of clinical testing compared to a decade ago.

Nevertheless, more innovative incentives are required to entice pharmaceutical companies to invest in antibiotic research through the later stages of clinical testing. One approach gaining traction is a unique payment model similar to Netflix’s subscription system.

In the UK, the National Health Service (NHS) piloted two new antibiotics using the Netflix-style payment model – Pfizer’s Zavicefta (ceftazidime/avibactam) and Shionogi’s Fetcroja (cefiderocol). Now, the NHS is looking to expand the scheme and is seeking input from the pharmaceutical industry, patients, caregivers, and academics to explore proposals of doubling annual payments for antibiotic contracts from £10 million ($19 million) to £20 million ($38 million) where “outstanding clinically based criteria are met.”

Across the Atlantic, the US has already adopted similar subscription payment models for antiviral treatments of Hepatitis C, highlighting the viability of this approach for tackling antibiotic resistance.

“While antibiotics remain critical, there is also renewed interest in vaccines, especially those utilising mRNA technologies, which have proven incredibly effective,” added Professor Blaskovich. “Unlike antibiotics, vaccines can be lucrative products for pharmaceutical companies, sparking increased interest in their development.”

To further promote antibiotic discovery, IMB’s Community for Open Antimicrobial Drug Discovery (CO-ADD) is providing researchers with free screening of compounds for antimicrobial activity, fostering collaboration and innovation in the fight against superbugs.

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