Antibiotic business model needs overhaul

Current model leads to antibiotic overconsumption and provides insufficient rewards to drive innovation, say top researchers

Academics from the Boston University School of Law and London School of Economics, among others, have written an essay in PLoS Medicine pointing out the ineffectiveness of the model.

Health care workers are increasingly cautious about prescribing new antibiotics due to the threat of resistance, but this dynamic is working against investments, they write.

Since drug companies obviously want to sell their new products, the key question is how to attract pharmaceutical innovators – both small- and medium-sized enterprises and larger multinational companies – to invest in antibiotic research and development.

The solution is a model that increases incentives for investing as well as delinks rewards from sales volumes, say the authors.

Incentives should be directed towards the development of new antibiotics intended for last-resort use, as well as new agents with immediate therapeutic value due to high levels of resistance.

“The delinkage principles applied to antibiotics is a powerful one and has attracted attention … from key figures in industry and high-level policy circles in Europe and the US,” they write.

“Global political commitment is needed now to transform antibiotic delinkage from a promising idea into reality.”

The UK’s Antimicrobial Resistance Review, led by economist Jim O’Neill, has also proposed partial or full delinkage.

“With this growing focus on antibiotic delinkage, we see the need for a global conversation,” conclude the authors.

PLoS Medicine 2016; online 15 June

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