Transferable Exclusivity Vouchers and Incentives for Antimicrobial Development in the European Union

In 2019, nearly 5 million deaths globally were associated with infections from bacteria with antimicrobial resistance (AMR). Despite the growing need for effective drugs treating patients with infections from resistant bacteria, the development pipeline is limited, and few new antibiotics offer substantial benefits over existing options. Global concern over antibiotic innovation has led policymakers to consider a range of solutions. In June 2022, the European Commission (EC) released a report that suggested offering transferable exclusivity vouchers (TEVs) to encourage development of new antimicrobial drugs. TEVs have been proposed in other contexts, but given the EC’s renewed interest, we review the parameters of a TEV and their strengths and limitations as a tool for the EC to enhance antimicrobial innovation. We conclude that the EC conception of TEVs suffers from the same problems with cost and inefficiency that have undermined such proposals in the past