Shionogi Europe and NHS England agree on antibiotic subscription model

Shionogi Europe has entered into an agreement with NHS England to initiate an innovative subscription payment model for the reimbursement of Fetroja (cefiderocol) in England.

As part of the model, companies will be paid a fixed amount for antimicrobials based on a health technology assessment of their value to the NHS, as opposed to the volumes used. Pull incentives like this payment model will help to encourage the research and development of critically needed antibiotics.

The deal comes after the National Institute for Health and Care Excellence’s (NICE) draft guidance recommending Fetcroja, issued in April 2022, for the treatment of severe multidrug-resistant aerobic Gram-negative bacterial infections.

The guidance also specified that the drug should be restricted for use as risk-based empiric treatment, or in cases of difficult to treat resistant infections, where few alternative treatment options exist.

Fetcroja is one of two antimicrobial products – the other being Zavicefta (ceftazidime-avibactam), manufactured by Pfizer – to be selected and made available under the scheme run by NICE and NHS England. Both drugs address vital disease areas of unmet need, in the UK and internationally, for treating serious infections including blood stream infection (BSI), sepsis and hospital- or ventilator-acquired pneumonia.

“We are delighted that NICE and NHS England have recognised the important role of Cefiderocol as an option to treat some of the most serious multidrug-resistant infections and its value to healthcare systems and society,” said Mark Hill, senior vice president, global head of market access, Shionogi.

He added: “Antimicrobial resistance is becoming a significant global threat and subscription-style schemes like this help to ensure that antibiotics are used to benefit patients who need them and according to effective stewardship principles to limit the potential development of resistance.”

NICE considered the potential long-term population benefits of Fetcroja, including the ‘insurance/diversity’ value of having additional antimicrobial treatments available for the future, and the ‘enablement’ value linked with the continued ability to provide other healthcare – such as chemotherapy and surgical procedures – that might otherwise be compromised by increasing antimicrobial resistance (AMR).

AMR is a serious health burden, resulting in more than 700,000 deaths worldwide and 5,000 deaths each year in England from infections with multidrug-resistant bacteria. If the issue is left unaddressed, AMR is predicted to result in ten million deaths every year globally by 2050.