Legislation aims to expand antibiotic pipeline, address antibiotic resistance

Antibiotic resistance is one of the greatest global public health concerns and is projected to be so for the next three decades. In the United States alone, 2.8 million people contract an antibiotic-resistant infection, killing more than 35,000 people each year.

Approximately 15 percent of COVID-19 patients suffer from secondary bacterial infections that become deadly, including patients afflicted by superbugs resistant to antibiotics.

And from a financial perspective, bacterial resistance costs $20 billion in additional U.S. medical expenses annually.

Considering the extent of this problem, one might think the pharmaceutical industry would be keen to create drugs to treat resistance. The reality is quite the opposite.

“Major pharmaceutical companies have largely abandoned antibiotic development, in favor of more lucrative disease areas, and the small companies left are struggling to stay afloat,” writes Wes Kim, senior officer at the Pew Charitable Trusts’ Antibiotic Resistance Project.

About 90 percent of antibiotics are being developed by small companies, several of which have filed for bankruptcy.

In an analysis published this month, Kim explains that compared to cancer, diabetes, and other chronic diseases, antibiotics are taken by patients for only a few days, making them “unsustainable” from a business perspective. From 2014 to 2016, drug companies made a profit of more than $8 billion on cancer drugs but netted a loss of $100 million on antibiotics, just as one example.

Now a recent federal bill aims to address the antibiotic pipeline through prepaid subscription government contracts. Sponsored by U.S. Sens. Michael Bennet (D-CO) and Todd Young (R-IN) and named after influential microbiologist Louis Pasteur, the PASTEUR Act (S. 4760), or “The Pioneering Antimicrobial Subscriptions To End Up Surging Resistance Act of 2020,” would “pay for new antibiotics based on their value to public health,” and not tie it to “how much of a drug is sold,” writes Kim. The bill would award federal contracts of up to $3 billion to drug makers for innovative antibiotics. For a fixed annual price paid to a drug company, the U.S. government can use whatever amount of antibiotics it needs. Similar models were implemented in the United Kingdom and Sweden.

The PASTEUR Act also promotes antibiotic stewardship programs, which encourage hospitals and other medical facilities to prevent the overuse of antibiotics. Pew research shows that 1 in 3 antibiotic prescriptions written by doctors—about 47 million prescriptions each year— are unnecessary.

Despite these efforts, even more may be required of health systems worldwide.

According to the World Economic Forum:

“Averting the worst-case scenario of ten million annual [antibiotic-resistant] deaths by 2050 would require an investment of $42 billion over the course of a decade. But that would represent a mere fraction of the huge economic cost of antibiotic resistance between 2015 and 2050 …which could top $100 trillion.”