De-linking reimbursement of antimicrobials from volumes sold: assessing alternative arrangements and implications for NICE appraisal

Project theme: Applied economic evaluation and policy analysis

The O’Neil report on antimicrobial resistance recommended a global system of market entry rewards for new antimicrobials, a key element of which was the need to de-link the payments received by manufacturers from the volumes of antimicrobials sold. 

One possibility is an ‘insurance-based’ scheme with the possible addition of a ‘cap and collar’ mechanism. This would be based on the estimated benefit of a new product over time and the calculation of periodic payments to the manufacturer to access the product.

EEPRU has been contacted with a view to undertaking research on the methods and evidence needed to establish appropriate levels of payments under such a scheme and the implications for the NICE technology appraisal process and methods for such products.

The EEPRU team for this project consists of researchers with extensive experience in analytical methods and their application to support resource allocation decisions, in particular those of NICE. It includes current and past members of the NICE technology appraisal and diagnostics advisory committees, the director of the York Evidence Review Group within CHE and the director of the NICE Decision Support Unit.

View the outline proposal (PDF, 561KB)

Project aim

The aim of the project is to assess the implications for the NICE technology appraisal programme of an insurance-based approach to the reimbursement of new antimicrobials.

Project team

Mark Sculpher, Claire Rothery, Marta Soares, Karl Claxton, Beth Woods and Steve Palmer.


Rothery, C., Woods, B., Schmitt, L., Claxton, K., Palmer, S. and Sculpher, M. (2018) Framework for value assessment of new antimicrobials. Implications of alternative funding arrangements for NICE appraisal (PDF, 4MB). Policy Research Unit in Economic Evaluation of Health and Care Interventions. Universities of Sheffield and York. EEPRU Research Report 059. DOI: 


Project workshop 12 July 2017