Friday, November 18, 2011

Microbial Resistance

Here's the newly-unveiled European Commission action plan to address the threat of increasing antimicrobial resistance. The plan calls for better control of antibiotic use in both human and animal medicine, for exploration of alternatives to antibiotics, for international surveillance of the resistance problem, and for public/private support for the development of new antibiotics. That's the key issue. It's difficult to get industry interested in developing the new drugs because, as the action plan pithily puts it:

"Developing new, effective and safe antibiotics is more and more scientifically difficult and costly. Restrictions on the use of antibiotics deter investment. Pricing structure does not reward utility. The majority of antibiotics are administered for short periods. Generics take an increasing share of the antibiotic market."

In the US, Senators Blumenthal and Corker have introduced their bipartisan Generating Antibiotic Incentives Now ("GAIN") act. The plan is to reward manufacturers of new antibiotics with longer time on-patent. This approach has the political advantage of not costing the government much up front, but it may miss the mark. The difficulty is that the responsible plan for using any effective new antibiotic will likely involve not using it, so that it retains its potency and is taken off the shelf only to defeat multiply-resistant superbugs. That means the new product will not be flying off the shelves, so it's not clear how valuable a lengthier patent exclusivity period will be to the drug developer. Governments may have to make more direct payments to industry to encourage antibiotic development; or they may have to do the R&D themselves.

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