Population-Based Payments May Help Ensure Access To Life-Saving Antibiotics For Medicare Beneficiaries

In 2019, the Centers for Disease Control and Prevention (CDC) released an updated report on Antibiotic Resistance Threats in the United States, which includes a list of pathogen threats categorized as urgent, serious, and concerning. The new numbers are sobering: Nearly three million Americans contract antibiotic-resistant infections every year, and more than 35,000 people die as a result. Most alarming, the number of antibiotic-resistant infections that are considered urgent threats has increased since the 2013 publication of this report.

Part of the reason the number of pathogen threats has grown is because our current antibiotics are increasingly ineffective in combatting infections, and few new drugs are being developed. Antibiotic approvals rely on specific clinical trial requirements and narrow patient populations, which result in limited evidence demonstrating that the new drug is more effective than currently available alternatives. Treatment with new antibiotics also requires diagnostic capabilities that are not always available, making confident, well-targeted antibiotic prescribing challenging. Because different strains of bacteria carry different types of resistance, the number of cases for a given type of resistant infection may be small, resulting in limited use and low revenues for manufacturers, revenue that does not reflect the value of a new antibiotic in reducing transmission or avoiding infections in the course of treating other patients.