Madam Therapeutics

Antibiotic Awareness Week: getting the risk-reward ratio right for R&D to fight superbugs

Each November, World Antibiotic Awareness Week (WAAW) aims to increase global awareness of antibiotic resistance and to encourage best practices among the general public, health workers and policy makers to avoid the further emergence and spread of antibiotic resistance.

During this week, there is heightened attention for the fact that new antibiotics are imperative to overcoming the threat of AMR. Yet approvals for new antibiotics have declined for many years. The last new class of antibiotics was introduced in the 1980s. While the pharmaceutical industry has been extremely successful in introducing transformative new therapies in general, it is exiting the field of antibiotics. In this area, the classic business model – high-risk research with reward in case of success – simply does not work.

Experts agree that incentives for innovations are needed; and there are a number of initiatives underway. So far, governments have focused on push incentives such grants, tax credits or public-private collaborations. These are designed to lower the risks that come with the early stages of research and development. But the bankruptcy of the antibiotic-focused biopharmaceutical company Achaogen shows that subsidizing research is not enough. Solutions are needed along the whole value chain to crack the AMR problem.
There is a slow but positive shift in the policy landscape acknowledging the need for broader, more sustainable solutions, including market-based pull incentives. For example, in July 2019, the United Kingdom launched a pilot program to reimburse companies based on how valuable their drugs are to the National Health Service (rather than on the quantity of antibiotics they sell). And in the United States, the Centers for Medicare & Medicaid Services is also making changes to the way it reimburses hospitals for antibiotics and the treatment of AMR.
This is a good start, but given the exponential threat to life that AMR poses, it is not enough; we need to go a lot further to get the risk-ratio right and ensure the continued investment we need to find and develop new antibiotics.
This is an abbreviated version of a story originally published (in German) in the print edition of Frankfurter Allgemeine Zeitung (FAZ) on October 29, 2019.

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