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Amid rising concern over antimicrobial resistance, the U.K. has taken a major step toward becoming the first country to launch an experimental payment model for antibiotics, a move designed to usher in a new era of drug development and reimbursement.

The government completed a long-awaited cost-effectiveness review of two new antibiotics as part of a pilot program that would pay for the medicines using a so-called subscription model. The idea is to pay companies upfront fees based on the estimated value of benefits to patients and the country’s National Health Service, rather than payments based on volumes used.

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The government set an annual cap of 10 million pounds, or roughly $13 million, so that the maximum amount spent over a decade for the two antibiotics would not exceed about $260 million, based on recent exchange rates. The U.K. represents about 3% of the global pharmaceutical market, so the government determined as part of its calculations that this was a fair contribution.

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