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Highlights from NICE 2018: Tackling Antimicrobial Resistance Globally and Locally

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By Amanda Pulfer

pH Associates is delighted to have met with current and former clients at the NICE Conference #NICEConf18 and to have the opportunity to attend some thought-provoking breakout sessions.  Of particular interest was a topical session focused on ‘Tackling Antimicrobial Resistance Globally and Locally’, with Nick Crabb (Programme Director, Scientific Affairs, NICE), Susan Hopkins (Chair of ESPAUR, Public Health England) and Tessa Lewis (Chair, NICE Committee) proving to be informative speakers. 

As well as being reminded of the alarming data demonstrating the magnitude of upcoming challenges, the audience heard a GP perspective on the impact the spectrum of illness and risk, and the effects of cognitive and hindsight bias have on prescribing decisions. 

In addition, there was some interesting discussion on novel payment models and the challenges associated with the development of value-based payment systems for medicines in this disease area.

Important attributes of value described in the context of antimicrobial treatment included:

  • Health outcomes achieved
  • Microbiologic outcomes
  • Mode of action (which can influence the likelihood that mutations will result in antimicrobial resistance)
  • Diversity value
  • Insurance value.

Quality adjusted life years (QALYs), which are commonly used to assess value in healthcare decision-making, are not considered to be adequate in this environment as it is not possible to quantify all relevant attributes using this approach. The audience were made aware of a recent research project into HTA Methods, due to be published in the coming months, which considers this topic in more detail. 

Due to the complexity of the area, the concluding message was that expert opinion should be given an increased weighting, alongside use of surveillance data, when assessing value in relation to antimicrobial treatment.

The need for an improved understanding of care pathways and outcomes was also a topic for discussion including the impact of diagnostics and safe stopping strategies. 

pH Associates has experience in conducting Real World Evidence (RWE) studies in the area of antimicrobials and would be happy to meet to discuss this and other RWE needs. Please contact Sam Oliver samoliver@phassociates.com or Amanda Pulfer amandapulfer@phassociates.com, joint Managing Directors, to arrange a meeting.

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