How should the value attributes of novel antibiotics be considered in reimbursement decision making?

Morton, Alec and Colson, Abigail and Leporowski, Axel and Trett, Anna and Bhatti, Taimur and Laxminarayan, Ramanan (2019) How should the value attributes of novel antibiotics be considered in reimbursement decision making? Medical Decision Making Policy & Practice. ISSN 2381-4683 (https://doi.org/10.1177/2381468319892237)

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Abstract

Antibiotics have revolutionised the treatment of bacterial infections. However, it is widely held that there is underinvestment in antibiotics research and development relative to the socially optimal level for a number of reasons. In this paper we discuss whether existing Health Technology Assessment (HTA) procedures recognise the full economic and societal value of new antibiotics to patients and society when making reimbursement decisions. We present three recommendations for modelling the unique attributes of value that are specific to novel antibiotics. We find, based on a review of the literature, that some of the value elements proposed by our framework have previously been discussed qualitatively by HTA bodies when evaluating antibiotics, but are not yet formally captured via modelling. We present a worked example to show how it may be possible to capture these dimensions of value in a more quantitative manner. We conclude by answering the question of the title as follows: the unique attributes of novel antibiotics should be considered in reimbursement decision making, in a way which captures the full range of benefits these important technologies bring to patients, healthcare systems, and society.

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