Table 1:

Potential European Financing Models for Antibacterial Pull Incentives

Financing Model	Definition	Requires Regular National Appropriations	Financed Through National Healthcare Budget
DRG carve-out	Paying separately for the antibiotic, outside of the standard DRG used for hospital reimbursement	No	Yes
Transferable exclusivity voucher	Granting a voucher in exchange for the successful regulatory approval of an antibiotic meeting’s predefined specifications; the voucher gives a saleable legal right to extend the monopoly time period of any patented medicine	No	Yes
Stewardship taxes	Any national tax aimed to encourage antibiotic stewardship, for example, a tax on veterinary antibiotic utilization	Possibly	Possibly
EMA antibiotic fee (“pay or play”)	A fee on all marketing authorizations (human and veterinary) to the EMA, except those for human antibiotic medicines	No	Indirectly

Abbreviation: DRG, diagnosis-related group; EMA, European Medical Agency.