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Assessing the Value of New Antimicrobials: Evaluations of Cefiderocol and Ceftazidime-Avibactam to Inform Delinked Payments by the NHS in England

Author

Listed:
  • Beth Woods

    (University of York)

  • Ben Kearns

    (University of Sheffield)

  • Laetitia Schmitt

    (University of York)

  • Dina Jankovic

    (University of York)

  • Claire Rothery

    (University of York)

  • Sue Harnan

    (University of Sheffield)

  • Jean Hamilton

    (University of Sheffield)

  • Alison Scope

    (University of Sheffield)

  • Shijie Ren

    (University of Sheffield)

  • Laura Bojke

    (University of York)

  • Mark Wilcox

    (University of Leeds and Leeds Teaching Hospitals)

  • William Hope

    (University of Liverpool)

  • Colm Leonard

    (Manchester University NHS Foundation Trust, Wythenshawe Hospital)

  • Philip Howard

    (University of Leeds
    NHS England)

  • David Jenkins

    (University Hospitals of Leicester NHS Trust)

  • Alan Ashworth

    (Manchester University NHS Foundation Trust)

  • Andrew Bentley

    (University of Manchester NHS Foundation Trust
    Manchester Academic Health Sciences Centre)

  • Mark Sculpher

    (University of York)

Abstract

Objectives The UK has recently established subscription-payment agreements for two antimicrobials: cefiderocol and ceftazidime-avibactam. This article summarises the novel value assessments that informed this process and lessons learned for future pricing and funding decisions. Methods The evaluations used decision modelling to predict population incremental net health effects (INHEs), informed by systematic reviews, evidence syntheses, national surveillance data and structured expert elicitation. Results Significant challenges faced during the development of the evaluations led to profound uncertainty in the estimates of INHEs. The value assessment required definition of the population expected to receive the new antimicrobials; estimating value within this heterogenous population; assessing comparative efficacy using antimicrobial susceptibility data due to the absence of relevant clinical data; and predicting population-level benefits despite poor data on current numbers of drug-resistant infections and uncertainties around emerging resistance. Though both antimicrobials offer the potential to treat multi-drug resistant infections, the benefits estimated were modest due to the rarity of true pan-resistance, low life expectancy of the patient population and difficulty of identifying and quantifying additional sources of value. Conclusions Assessing the population INHEs of new antimicrobials was complex and resource intensive. Future evaluations should continue to assemble evidence relating to areas of expected usage, patient numbers over time and comparative effectiveness and safety. Projections of patient numbers could be greatly enhanced by the development of national level linked clinical, prescribing and laboratory data. A practical approach to synthesising these data would be to combine expert assessments of key parameters with a simple generic decision model.

Suggested Citation

  • Beth Woods & Ben Kearns & Laetitia Schmitt & Dina Jankovic & Claire Rothery & Sue Harnan & Jean Hamilton & Alison Scope & Shijie Ren & Laura Bojke & Mark Wilcox & William Hope & Colm Leonard & Philip , 2025. "Assessing the Value of New Antimicrobials: Evaluations of Cefiderocol and Ceftazidime-Avibactam to Inform Delinked Payments by the NHS in England," Applied Health Economics and Health Policy, Springer, vol. 23(1), pages 5-17, January.
  • Handle: RePEc:spr:aphecp:v:23:y:2025:i:1:d:10.1007_s40258-024-00924-x
    DOI: 10.1007/s40258-024-00924-x
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    References listed on IDEAS

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    1. Laura Bojke & Marta O. Soares & Karl Claxton & Abigail Colson & Aimée Fox & Chris Jackson & Dina Jankovic & Alec Morton & Linda D. Sharples & Andrea Taylor, 2022. "Reference Case Methods for Expert Elicitation in Health Care Decision Making," Medical Decision Making, , vol. 42(2), pages 182-193, February.
    2. Gotham, Dzintars & Moja, Lorenzo & van der Heijden, Maarten & Paulin, Sarah & Smith, Ingrid & Beyer, Peter, 2021. "Reimbursement models to tackle market failures for antimicrobials: Approaches taken in France, Germany, Sweden, the United Kingdom, and the United States," Health Policy, Elsevier, vol. 125(3), pages 296-306.
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