title: A systematic review and critical assessment of incentive strategies for discovery and development of novel antibiotics.
abstract: Despite the growing threat of antimicrobial resistance, pharmaceutical and biotechnology firms are reluctant to develop novel antibiotics because of a host of market failures. This problem is complicated by public health goals that demand antibiotic conservation and equitable patient access. Thus, an innovative incentive strategy is needed to encourage sustainable investment in antibiotics. This systematic review consolidates, classifies and critically assesses a total of 47 proposed incentives. Given the large number of possible strategies, a decision framework is presented to assist with the selection of incentives. This framework focuses on addressing market failures that result in limited investment, public health priorities regarding antibiotic stewardship and patient access, and implementation constraints and operational realities. The flexible nature of this framework allows policy makers to tailor an antibiotic incentive package that suits a country's health system structure and needs.
authors.affiliation: LSE Health, Department of Social Policy, London School of Economics and Political Science, London, UK.
authors.forename: Matthew J
authors.initials: MJ
authors.lastname: Renwick
authors.affiliation: LSE Health, Department of Social Policy, London School of Economics and Political Science, London, UK.|Missouri Orthopaedic Institute, University of Missouri, Columbia, MO, USA.
authors.forename: David M
authors.initials: DM
authors.lastname: Brogan
authors.affiliation: LSE Health, Department of Social Policy, London School of Economics and Political Science, London, UK.
authors.forename: Elias
authors.initials: E
authors.lastname: Mossialos
mesh_terms: D000900:Anti-Bacterial Agents / Q000737:chemistry / Q000302:isolation & purification* / Q000494:pharmacology*; D003661:Decision Support Techniques; D055808:Drug Discovery / Q000379:methods* / Q000639:trends*; D014943:Global Health; D006291:Health Policy; D006801:Humans; D009042:Motivation
chemical_list: D000900:Anti-Bacterial Agents