Pilot of new health technology evaluation process for antimicrobials

Research to develop novel antibiotics has in recent years been seen as commercially unattractive due to limited use of any new antimicrobials and associated poor return on investment. To support international work to tackle antimicrobial resistance and encourage investment in drug development, the National Institute for Health and Care Excellence (NICE) are working with NHS England and NHS Improvement (NHSE&I) to test a new health technology evaluation process for antimicrobials.  This value-based pilot will involve a subscription payment model and two antimicrobial products have been selected for the pilot – ceftazidime/avibactam (Zavicefta, Pfizer) launched in 2017 and cefiderocol (Fetcroja, Shionogi) launched in 2020. Both are active against Gram negative organisms including resistant strains of E. coli and Klebsiella.  

Full details of the pilot are available here.

Scottish Medicines Consortium (SMC), Scottish Antimicrobial Prescribing Group (SAPG), NSS National Procurement and the Scottish Government are involved as observers in the NICE/NHSE&I pilot process. Whilst the pilot is ongoing SMC will not issue any further advice for these products. SMC published not recommended advice in the absence of a submission from the holder of the marketing authorisation for ceftazidime/avibactam (SMC No 1307/18) and cefiderocol has not been assessed. The pilot is expected to be completed in early 2022.

SMC and SAPG advise that during the pilot these medicines can be accessed for individual patients where required through local Health Board processes based on appropriate specialist advice.