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Combatting the Antimicrobial Resistance Timebomb With Real World Data

antimicrobial

Dr Rachel Freeman and Jonathan Green

AMR Programme Lead and Programme Management Director, Real World Solutions, IQVIA UK & Ireland

Global human data science company, IQVIA, highlight ways in which real-world data can reduce the threat posed by antimicrobial resistance in the UK.

Since the discovery of penicillin by Sir Alexander Fleming at St Mary’s Hospital in London in 1928, we have relied on the availability of effective antibiotics to treat bacterial infections, resulting in a significant reduction in morbidity and mortality. Further, we are reliant on these crucial medicines for the safe delivery of healthcare, including the administration of chemotherapy to treat cancer and the performance of routine and emergency surgery. Though antibiotic discovery expanded dramatically after the discovery of penicillin, only two new classes of antibiotics have reached the market since the 1960s.

Antimicrobial resistance (AMR) occurs when microbes – such as bacteria, viruses, and fungi – evolve to resist the action of antimicrobials (including antibiotics), making them ineffective. The UK Government considers AMR to present a significant threat to society, including AMR on the National Risk Register of Civil Emergencies and, in 2014, commissioning the Review on AMR, which estimated that globally, 10 million people per year would die as a result of AMR-related illness by 2050. Using 2018 data, analysis conducted by Public Health England (now the UK Health Security Agency), estimated that just over 17,000 patients in England had a bloodstream infection (a serious and life-threatening form of infection) caused by bacteria resistant to one or more key antibiotics, an increase of 32 per cent compared to 2014.

In 2019, the UK Government published its five-year National Action Plan for tackling AMR. With a lack of novel antimicrobials in the pipeline, key commitments in the action plan included investment in the development of new therapeutics, diagnostics, and vaccines, and optimising the use of existing antimicrobials. Overuse of antimicrobials is a known driver of resistance and therefore, reducing inappropriate antimicrobial prescribing is a critical part of the strategy.

“The UK Government considers AMR to present a significant threat to society.”

Real-world data exists in abundance in the healthcare sector, captured routinely as a result of healthcare interaction. Its effective utilisation will be crucial for driving antimicrobial discovery, generating evidence and insights into the burden of AMR, and guiding optimal prescribing of antimicrobial therapies. As part of its AMR Programme, IQVIA is working on a range of solutions to optimise antimicrobial prescribing, including IQVIA’s Antimicrobial Dashboards, which will be launched later this year. This solution employs IQVIA’s Hospital Pharmacy Audit and presents standardised antimicrobial usage data via interactive dashboards. These insights can empower those responsible for improving antimicrobial prescribing at a local, regional, and national level to identify unusual patterns and target the implementation of antimicrobial stewardship interventions.

Additionally, in support of guiding appropriate prescribing, IQVIA has collaborated with the University of Liverpool, developing systems that integrate real-world data into point-of-care decision-making. AMR is a complex problem that requires strong leadership across all the sectors tasked with responding to the significant threat it poses to healthcare – to make a meaningful impact, cross-sector collaboration is crucial. IQVIA’s approach to tackling AMR involves engaging early with government bodies, academic institutes, the life sciences industry, and patient advocacy groups to create solutions that are robust, relevant, and scalable, ensuring that the whole health system benefits from innovative and effective solutions.

Curia’s NHS and Life Sciences Commission

Following the successful launch of the NHS Innovation and Life Sciences Commission’s 2022 Report, the Commission will appraise the outlined recommendations in 2023. This will allow a measurement of success to be taken on each implementation and a review of new priorities for the NHS and life sciences industry. The Commission will continue to review case studies to highlight best practice for the 2022 recommendations. Through a series of sprints, the Commission will highlight real-world experiences in regions across the UK. Through targeted health data mapping, relevant areas of unmet need and health inequalities can be chosen. Each sprint may appraise one or multiple topic areas from the 2022 report.

The Commission will also hold dedicated inquiry sessions into specific system-level and therapeutic areas of focus. Using the same methodology, the inquiries will provide opportunities for the Commission to gain implementable solutions to these areas and develop similar policy recommendations and reports.

The Commission will continue periodic consultation with selected advisory group bodies and sponsors to steer the methodology and direction of the 2023 activities.

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