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. 2016 Feb;69(2):73-88.
doi: 10.1038/ja.2015.98. Epub 2015 Oct 14.

A systematic review and critical assessment of incentive strategies for discovery and development of novel antibiotics

Matthew J Renwick  1 , David M Brogan  1   2 , Elias Mossialos  1
Affiliations

A systematic review and critical assessment of incentive strategies for discovery and development of novel antibiotics

Matthew J Renwick et al. J Antibiot (Tokyo). 2016 Feb.

Abstract

Despite the growing threat of antimicrobial resistance, pharmaceutical and biotechnology firms are reluctant to develop novel antibiotics because of a host of market failures. This problem is complicated by public health goals that demand antibiotic conservation and equitable patient access. Thus, an innovative incentive strategy is needed to encourage sustainable investment in antibiotics. This systematic review consolidates, classifies and critically assesses a total of 47 proposed incentives. Given the large number of possible strategies, a decision framework is presented to assist with the selection of incentives. This framework focuses on addressing market failures that result in limited investment, public health priorities regarding antibiotic stewardship and patient access, and implementation constraints and operational realities. The flexible nature of this framework allows policy makers to tailor an antibiotic incentive package that suits a country's health system structure and needs.

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Figures

Figure 1
Figure 1
Generalized search protocol.
Figure 2
Figure 2
Push strategies. IMI, Innovative Medicines Initiative; ND4BB, New Drugs for Bad Bugs; R&D, research and development.
Figure 3
Figure 3
Outcome-based pull strategies.
Figure 4
Figure 4
Lego-regulatory pull strategies. AMR, antimicrobial resistance; IP, intellectual property; US, United States.
Figure 5
Figure 5
Hybrid strategies. AMC, Advanced Market Commitment; EU, European Union; LPAD, Limited Population Antibacterial Drug; NTAP, new technology add-on payment; PDP, product-development partnership; P4P, pay-for-performance; US, United States.
Figure 6
Figure 6
Mechanisms to fund incentives. R&D, research and development.
See this image and copyright information in PMC

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