‘Pull incentives’ could help fight antibiotic resistance: report

Canada needs to catch up to other countries when accessing crucial new antibiotics, says a recent report from the Council of Canadian Academies. Only three of the 18 new antibiotics launched between 2010 and 2019 were available in Canada as of May 2023, the report found. Other European and G7 countries have a much broader availability of new antibiotics. It’s a crucial issue, with antibiotic-resistant infections associated with more than 14,000 deaths in Canada in 2018 and directly attributable to 5,400. If antibiotic resistance rates continue to increase, by 2050, resistance rates to first-line antimicrobials could rise to 40%, causing 396,000 deaths between 2020 and 2050. Read: The fight against antibiotic resistance is growing more urgent, but artificial intelligence can help “The consequences of antimicrobial resistance are real and growing, while at the same time, companies are leaving the commercial space,” Dr. Andrew Morris, chair of the expert panel that created the report, said in a press release. “New and accessible treatments are critical to preserve the life-saving effectiveness of antimicrobials for everyone in Canada, and particularly the most vulnerable.” It recommends subscription pull incentives—when countries pay yearly amounts to manufacturers for access to needed antibiotics—to help solve the problem. It says a fair cost for Canada for the needed antimicrobials would be between $14.5 million and $18 million per year per drug over a decade. Payment levels would vary based on the drug’s importance to the Canadian healthcare system. Read: Nasal discharge colour a poor guide for antibiotic use in acute sinusitis They would be effective if combined with other countries also establishing similar pull incentives. Complementary “push incentives” such as efficient regulatory review, offering the surveillance data required, and boosting the supply of rapid diagnostics will also help. These changes would bring more new antibiotics to Canada and encourage pharmaceutical companies to invest in developing new ones. Read: Quebec pharma company creates generic antibiotic to help combat shortages Globally, the pace of creating new antimicrobial medications is falling behind the rise of antimicrobial resistance. Pharmaceutical companies aren’t eager to invest in them because antibiotic prescriptions are for short courses, stewardship limits their use, there is competition from generics, they can succumb to antimicrobial resistance, and they're challenging to organize clinical trials for. “This is a global issue. The pipeline is dry, and companies are not investing in antimicrobial development, so we have to create incentives to correct this,” said Jean-Éric Tarride, a coauthor of the report and chair of Health Technology Management at McMaster University. “If Canada is to adopt a model like this and participate in a global pull incentive, we will join other countries such as the U.K., Sweden, the U.S., and Japan in signaling that there is desire to invest in these high-value medications.” Read: Systematic review confirms role of probiotic use with antibiotics

‘Pull incentives’ could help fight antibiotic resistance: report

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