The annual impact of antimicrobial resistance is expected to reach up to $283bn by 2050. Point-of-care diagnostics, deincentivisation of oversupply and appropriate prescribing are a must.
Today clinicians, pharmaceutical companies and others are in Canberra to discuss bringing the UK’s “Netflix” model for antimicrobials to Australia, amid growing levels of resistance.
According to the lead of CSIRO’s Minimising Antimicrobial Resistance Mission Professor Branwen Morgan, 14 Australians die per day of antimicrobial resistance-related causes.
“While [a small proportion of] drug-resistant infections are going down … a number are going up,” Professor Morgan told The Medical Republic.
“We’ve now got infections where if the antibiotic fails, there is no plan B, there is no backup.
“That’s a really serious situation to be in.”
Since 2011, there has been an influx of around two dozen new antimicrobials into the global market.
Yet only three are available in Australia and none are available on the PBS, said Professor Morgan.
“We have an access issue in Australia, and we also have an equity issue,” she said.
As such, CSIRO, clinicians, pharmaceutical companies and other health organisations have taken to Canberra today – day one of antimicrobial resistance week – to discuss a new model of antimicrobial procurement to address this “market failure”.
Under the so-called “Netflix” model for antimicrobials in the UK, NHS England pays a fixed annual subscription fee to pharmaceutical companies for access to new antibiotics.
The idea is that the guaranteed fee should negate any incentive for companies to oversell the products and incentivises antibiotic innovation.
The model has been used in Australia before. In 2016, the government struck a five-year subscription deal with a group of pharmaceutical companies for unlimited access to the novel hepatitis C drug Sofosbuvir.
The deal reduced per patient costs by an estimated 85%.
The model may not, however, address concerns over appropriate prescription of antibiotics.
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Speaking on antimicrobial resistance, AMA president Dr Danielle McMullen said the dangers should be front of mind for the governments when discussing policy, such as the expansion of prescribing rights for non-medical health professionals.
“Antibiotics are an important part of medicine, but it is absolutely critical they are prescribed carefully and responsibly,” Dr McMullen said.
“Over the coming decades [antimicrobial resistance] is predicted to become one of the leading causes of death and could be responsible for 50 million deaths each year by 2050.
“It’s estimated that by 2050 the annual impact of antimicrobial resistance on the Australian economy will be between $142 billion and $283 billion and between $80 and $90 trillion worldwide.”
Dr McMullen raised concerns over returning to the medical dark ages if resistance to antimicrobials is not appropriately addressed.
“Now is the time for strong and sustained action on antimicrobial resistance.”
Professor Morgan emphasised the importance of point-of-care diagnostics.
“We should be advocating for diagnostics and point of care diagnostics that can make sure that when the antibiotic is prescribed by whoever it’s prescribed by, it’s appropriate and it’s going to be effective,” she said.
In a newly released communique, Research Australia encouraged a patient-centred, collaborative approach to prescribing antibiotics.
“While broadening the scope of antimicrobial prescribers, strong communication between pharmacists and general practitioners (GPs) is necessary,” it reads.
“In addition, access to affordable diagnostic tools and clear training guidelines will help ensure proper diagnosis and treatment.”
The communique also encouraged delayed prescribing.
“Delayed prescribing is a strategy where a healthcare provider issues a prescription for antibiotics but advises the patient to wait before filling it, allowing time to see if symptoms improve without medication,” it reads.
“This approach helps reduce unnecessary antibiotic use, as some infections resolve on their own.”
