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Friday, January 15th, 2021

Age of antibiotic resistance being met with newly unveiled PASTEUR Act in U.S. House

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In the United States, more than 2.8 million antibiotic-resistant infections occur annually, killing some 35,000 people, yet scant financial incentives exist to develop drugs that could treat many of these infections, according to the Centers for Disease Control and Prevention (CDC).

In response, a bipartisan bill introduced this week in the U.S. House of Representatives would establish a program to develop antimicrobial and antibiotic innovations targeting the most challenging pathogens and most threatening infections. 

“The public health, economic and national security threats of antimicrobial resistance could have serious implications if left unresolved,” said bill cosponsor U.S. Rep. Drew Ferguson (R-GA). “Pandemic preparedness is first and foremost about having the right preventative tools available, and antibiotics are without question one of these key tools.” 

Rep. Ferguson on Dec. 9 introduced the Pioneering Antimicrobial Subscriptions to End Upsurging Resistance (PASTEUR) Act, H.R. 8920, with bill sponsor U.S. Rep. Mike Doyle (D-PA). The measure is companion legislation to S. 4760, introduced Sept. 30 by U.S. Sens. Michael Bennet (D-CO) and Todd Young (R-IN). 

The bill reflects the priorities and recommendations promoted by the CDC, the Infectious Diseases Society of America (IDSA), and other experts in the field of antibiotic resistance via increased public health preparedness that would keep new antibiotics on the market and improve appropriate antibiotic use across the healthcare system, according to the lawmakers.

For instance, while current contracts between the federal government and drug makers base payment on volume, the PASTEUR Act would establish a subscription-style model that would offer antibiotic developers an upfront payment in exchange for access to their antibiotics, in turn encouraging innovation and ensuring the nation’s healthcare system is better prepared to treat antibiotic-resistant infections, the lawmakers said. 

“Antimicrobial resistance is an urgent public health threat that requires a comprehensive, bipartisan solution,” said Rep. Doyle. “Infectious disease experts agree that our next public health crisis could be caused by drug-resistant infections, and we mustn’t be caught flat-footed.” 

IDSA President Dr. Barbara Alexander, a medicine and pathology professor at the Duke University School of Medicine, pointed out that antibiotic-resistant infections “seriously jeopardize” the nation’s ability to provide complex medical care, including transplants, cancer chemotherapy, care for patients seriously ill with COVID-19, and other surgeries. “IDSA is proud to support the PASTEUR Act to ensure we have the antibiotics we need and to drive the appropriate use of antibiotics to protect their effectiveness,” she said.

In addition to the IDSA, other public health experts agree that the PASTEUR Act could be a critical component in the nation’s preparedness and response to antimicrobial resistance.

Dr. Cornelius Clancy, associate chief of infectious diseases at the University of Pittsburgh, said that growing antibiotic resistance coupled with the fragile antibiotic pipeline leaves Americans extremely vulnerable. “The PASTEUR Act,” he added, “will sustain antibiotic research and development and provide essential new resources to support antibiotic stewardship.” 

Ken Thorpe, chairman of the Partnership to Fight Chronic Disease, said that in the battle between innovation and resistance, resistance is currently winning. “COVID-19 has underscored the importance of preparedness and the threat of AMR looms large,” he said. “The PASTEUR Act is an important step forward in that fight against antimicrobial resistance and infectious disease.”

If enacted, the proposed bill also would build on existing frameworks to improve usage of the CDC National Healthcare Safety Network and other programs to collect and report on antibiotic use and resistance data, and would include transition measures, such as smaller subscription contracts, to support new antimicrobial drug developers that need a financial lifeline, the lawmakers explained.

The Senate version of the bill is under consideration by the U.S. Senate Health, Education, Labor, and Pensions Committee, while the House version has been referred to several committees for review.