The Diagnosis Confirmation Model (DCM) includes a dual-pricing mechanism designed to support value-based pricing of novel antibiotics while improving the alignment of financial incentives with their optimal use in patients at high risk of drug-resistant infections. DCM is a market-based model and complementary to delinked models. Policymakers interested in stimulating antibiotic innovation could consider tailoring the DCM to their reimbursement systems and incorporating it into the suite of incentives to improve the economics of antibiotics.
The Review on Antimicrobial Resistance: Chaired by JimO'Neil, Tackling Drug-Resistant Infections Globally: Final Report and Recommendations, May2016; World Bank, Drug-Resistant Infections: A Threat to Our Economic Future (Discussion Draft), Washington, D.C., 2016.
G.Raman, E.Avendano, S.Berger, and V.Menon, “Appropriate Initial Antibiotic Therapy in Hospitalized Patients with Gram-Negative Infections: Systematic Review and Meta-analysis,”BMC Infectious Diseases15 (2015): 395; M. D. Zilberberg, A. F. Shorr, S. T. Micek, C. Vazquez-Guillamet, and M. H. Kollef, “Multi-drug Resistance, Inappropriate Initial Antibiotic Therapy and Mortality in Gram-Negative Severe Sepsis and Septic Shock: A Retrospective Cohort Study,” Critical Care 18 (2014): 596; P. Viale, M. Giannella, R. Lewis, E.M. Trecarichi, N. Petrosillo, and M. Tumbarello, “Predictors of Mortality in Multidrug-Resistant Klebsiella Pneumoniae Bloodstream Infections,” Expert Review of Anti-infective Therapy 11, no. 10 (2013): 1053-1063; A. F. Shorr, M. D. Zilberberg, S. T. Micek, and M. H. Kollef, “Predictors of Hospital Mortality among Septic ICU Patients with Acinetobacter spp. Bacteremia: A Cohort Study,” BMC Infectious Diseases 14 (2014): 572; T. P. Lodise Jr., N. Patel, A. Kwa, J. Graves, J. P. Furuno, E. Graffunder, B. Lomaestro, and J. C. McGregor, “Predictors of 30-Day Mortality among Patients with Pseudomonas Aeruginosa Bloodstream Infections: Impact of Delayed Appropriate Antibiotic Selection,” Antimicrobial Agents Chemotherapy 51, no. 10 (2007): 3510-3515; J. Rello, “Importance of Appropriate Initial Antibiotic Therapy and De-escalation in the Treatment of Nosocomial Pneumonia,” European Respiratory Review 16 (2007): 33-39.
6.
See supra note 5.
7.
J.Garnacho-Montero, A.Escoresca-Ortega, and E.Fernández-Delgado, “Antibiotic de-Escalation in the ICU: How Is It Best Done?”Current Opinion in Infectious Diseases28, no. 2 (2015): 193-198.
8.
See Garnacho-Montero, supra note 7.
9.
Id.
10.
F.Koechlin, P.Konijn, L.Lorenzoni, and P.Schreyer, “Comparing Hospital and Health Prices and Volumes Internationally: Results of a Eurostat/OECD Project,”OECD Health Working Papers, no. 75 (2014): at 11; V. Paris, M. Devaux, and L. Wei, “Health Systems Institutional Characteristics: A Survey of 29 OECD Countries,” OECD Health Working Papers, no. 50 (2010): at 36.
11.
D.Scheller-Kreinsen, W.Quentin, and R.Busse, “DRG-Based Hospital Payment Systems and Technological Innovation in 12 European Countries,”Value in Health14 (2011): 1166-1172.
12.
R.Busse, A.Geissler, W.Quentin, and M.Wiley, eds., Diagnosis-Related Groups in Europe. Moving Towards Transparency, Efficiency and Quality in Hospitals (Berkshire, England: Open University Press, 2011).
13.
See Scheller-Kreinsen, supra note 11; see Busse, supra note 12.
H. W.Boucher, P. G.Ambrose, H. F.Chambers, R. H.Ebright, A.Jezek, B. E.Murray, J. G.Newland, B.Ostrowsky, and J. H.Rex, on behalf of the Infectious Diseases Society of America, “White Paper: Developing Antimicrobial Drugs for Resistant Pathogens, Narrow-Spectrum Indications, and Unmet Needs,”Journal of Infectious Diseases216, no. 2 (2017): 228-236.
16.
D. A.Goff and T. M.FileJr., “The Evolving Role of Antimicrobial Stewardship in Management of Multidrug Resistant Infections Review Article,”Infectious Disease Clinics of North America30, no. 2 (2016): 539-551.
C.Årdal, J.-A.Røttingen, A.Opalska, A. J.Van Hengel, and J.Larsen, “Pull Incentives for Antibacterial Drug Development: An Analysis by the Transatlantic Task Force on Antimicrobial Resistance,”Clinical Infectious Diseases65, no. 8 (2017): 1378-1382.
19.
See Schaffer, supra note 14.
20.
See Årdal, supra note 18.
21.
P. J.Neumann, J. D.Chambers, F.Simon, and L. M.Meckley, “Risk-Sharing Arrangements That Link Payment for Drugs to Health Outcomes Are Proving Hard to Implement,”Health Affairs30, no. 12 (2011): 2329-2337.
TeamC, “Chennai Declaration: 5-Year Plan to Tackle the Challenge of Anti-microbial Resistance,”Indian Journal of Medical Microbiology32, no. 32 (2014): 221-228.