Weekend Healthcare Pulse: Antimicrobial Resistance - A Global Threat, An Innovation Imperative, The India Opportunity?

Research evidence excerpt

Weekend Healthcare Pulse: Antimicrobial Resistance - A Global Threat, An Innovation Imperative, The India Opportunity?

Nandan Kulkarni +91 22 6842 1436 nandan.kulkarni@bernsteinsg.com 3 July 2026

of deaths, and was directly attributable in about 18-20% of total

deaths. We believe this also results in an unsettling trend that India (1) UK’S ANTIBIOTIC STEWARDSHIP PROGRAM

has a large sepsis pool with our estimate of incidence at about 540 NHS England's Quality Premium, introduced way back in 2015,

to 640 per 100,000 population, and mortality of 25 to 30%. rewarded local Clinical Commissioning Groups financially for

cutting primary-care prescribing— where ~74–80% of antibioticsEXHIBIT 1: Multiple bacterial resistance mechanisms reduce are dispensed. This program targeted a 1% reduction in total items

antibiotic effectiveness, highlighting the need for rapid and a 10% cut in broad-spectrum use. Our research of follow-up

diagnostics and novel antibiotics study from Imperial/PHE evaluation suggests that ~8.2% relative

fall in total antibiotic items and an 18.9% drop in broad-spectrum

prescribing. On the supply side, the United Kingdom pioneered the

world's first "Netflix-style" subscription (pull) model — the mirror

image of Japan's demand-side fee. Since July 2022, NHS England

pays a fixed annual fee (initially up to £10 million/product) de-linked

from sales volume for Pfizer's ceftazidime-avibactam (Zavicefta)

and Shionogi's cefiderocol (Fetcroja), rewarding value to the health

system rather than units sold (NICE; Applied Health Econ & Health

Policy). In May 2024 the UK made this permanent with a ~£100

million/year budget across four value bands.

(2) SWEDEN LEADS AMONG EU COUNTRIES

Sweden's Strama program took a complementary route: a national