Table 4.
Criteria-Based Assessment of Recommended Incentive Strategy Using Modified Renwick et al18 Framework
| Incentive Strategy + Total Score | Improves NPV | Enables SME Participation | Enables Big Pharma Participation | Promotes Cooperation/ Synergy Among Key Players | Feasible Within Current Business Model | Piloted in Other Countries | Involves Delinking | Conditional Grants/Payments | Promotes Antibiotic Stewardship | Rewards Innovation | Improves Patient Access |
|---|---|---|---|---|---|---|---|---|---|---|---|
| Push Incentives | |||||||||||
| Open-source drug discovery (4) | ✓ | ✓ | X | ✓ | X | ✓ | X | X | X | X | X |
| Grants (4) | ✓ | ✓ | X | X | ✓ | ✓ | X | X | X | X | X |
| Tax incentives/ Credits (4) | ✓ | X | ✓ | X | ✓ | ✓ | X | X | X | X | X |
| Pull Incentives | |||||||||||
| Conservation-based market exclusivity (4) | ✓ | X | ✓ | X | ✓ | X | X | X | ✓ | X | X |
| Diagnosis confirmation model (1) | ✓ | X | X | X | X | X | X | X | X | X | X |
| Fee on antibiotic use (3) | ✓ | X | X | X | ✓ | X | X | X | ✓ | X | X |
| Increase antibiotic prices (4) | ✓ | X | ✓ | X | ✓ | X | X | X | ✓ | X | X |
| MER (fully delinked) (6) | ✓ | X | ✓ | X | X | ✓ | ✓ | X | ✓ | X | ✓ |
| MER (partially delinked) (5) | ✓ | X | ✓ | X | X | ✓ | ✓ | X | X | X | ✓ |
| Value-based reimbursement (5) | ✓ | X | ✓ | X | X | ✓ | X | ✓ | X | ✓ | X |
| Hybrid Incentives | |||||||||||
| OMA (5) | ✓ | ✓ | ✓ | X | X | X | X | X | X | ✓ | ✓ |
| ACE (5) | ✓ | X | ✓ | X | X | X | X | ✓ | ✓ | ✓ | X |
Notes: Adapted with permission from Renwick M, Brogan DM, Mossialos E. A systematic review and critical assessment of incentive strategies for discovery and development of novel antibiotics. J Antibiot (Tokyo). 2016;69(2):73–88. Copyright 2016 Springer Nature.18Abbreviations: NPV, net present value; SME, small-medium enterprise; MER, market entry reward; OMA, options market award; ACE, antibiotic conservation and effectiveness.