In a survey published this week in Antimicrobial Agents and Chemotherapy, University of Pittsburgh School of Medicine scientists concluded that the market has thus far failed to support new antibiotics for the increasing troubles of drug-resistant superbugs.
“New drugs against CRE (carbapenem-resistant Enterobacteriaceae) address a major, previously unmet medical need and are critical to save lives,” Dr. Cornelius Clancy, lead author, associate professor of medicine and director of the mycology program and Extensively Drug Resistant Pathogen Laboratory, said. “If the market can’t support them, then that is a chilling commentary on the future of antibiotic development. Without antibiotics against increasingly resistant bacteria and fungi, much of modern medicine may become infeasible, including cancer chemotherapies, organ transplantation and high-risk abdominal surgeries.”
Experts have previously cited $1 billion in sales to be the mark necessary to make a new antibiotic stick on the market. Clancy and his fellow investigators turned to U.S. prescription data to determine sales of the CRE antibiotic, and soon found that sales had only reached around $101 million annually. Worse, the projected market for such drugs is only $289 million.
This is in spite of the fact that CRE are called a nightmare bacteria by the Centers for Disease Control and Prevention, and CRE infections cause between 1.5 and 4.5 million hospitalizations throughout the world each year. Both the World Health Organization and Infectious Disease Society of America have agreed that CRE is one of the highest priority pathogens for developing new antibiotics. Since 2015, five CRE antibiotics have grabbed U.S. Food and Drug Administration approval, and their trials show them to be effective, but it’s not enough.
Just this year, one of the biopharmaceutical companies manufacturing such new drugs went bankrupt due to its affiliated losses. A major part of the problem is prescriptions. Reports have found that CRE antibiotics are being prescribed in only a quarter of the infection cases that would benefit from them.
The way forward, as Clancy and senior author Dr. M. Hong Nguyen, see it, is to introduce incentives to encourage sustainable antibiotic development and use of new drugs that are often more expensive starting out. They also want to see a cultural and behavioral shift among hospitals and clinics for faster use of new antibiotics. Education would be a big part of this.