There are a shrinking number of antibiotic drug makers and investors, who see little payoff in a market that reimburses new drugs on volume, rather than their benefits to public health, according to a new report from a trade group known as the Biotechnology Innovation Organization.
About 80% of new antibiotics that are being developed in clinical trials come from small, emerging biotechnology companies, as larger manufacturers have exited the market. And, over the past decade, venture capital funding for U.S. antibiotic development was 17 times less than for oncology drugs.
"The #1 issue is the market solution, so even though there's important stewardship that goes on, the thing that has to happen first is to incentivize those drugs to be made, designed and to be put through 10 years of clinical trials, which isn't happening right now," said David Thomas, vice president of industry research at BIO.
BIO and antibiotic experts point to a few factors that are leading to this decline. While Congress has created fast-track lanes for new antibiotic drugs, payment is still a big problem since most health systems—where the bulk of antibiotic-resistant bacteria has originated—pay for drugs based on how much they buy.
"Hospitals are trying to use the new ones as a last resort so that resistance doesn't develop right out of the gate," said David Hyun, who leads the Pew Charitable Trusts antibiotic resistance project, and was not involved in the study. He added that they also don't purchase a lot, especially as compared to drugs for chronic conditions. "The overarching challenge is how do we delink—specific for antibiotics—the value of these lifesaving drugs from the volume of sold, and, rather, try to put a value of public health value to it."
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