Pharmaceutical companies don’t want to invest in new antibiotics because they have a low financial return. The solution may go through the so-called “Netflix model”, but there are those who are skeptical.
Conspiracy theories surrounding the Big Pharma suggest that the medical community in general and the pharmaceutical companies in particular, especially the big industries, operate with sinister aims and against the public good. In addition, they are accused of hiding effective treatments and even causing or aggravating a wide range of diseases with the sole purpose of making a profit.
The term Big Pharma carries a negative connotation that highlights a supposed perverse nature it’s from unbridled profit of the pharmaceutical industry.
The first ever antibiotic, Arsphenamine, was first marketed in 1910 under the brand name Salvasan. In just over 100 years, antibiotics have dramatically changed modern medicine and extended average life expectancy by 23 years.
From 1928, with the discovery of penicillin, the golden age of antibiotic discovery began, which reached its peak in the 1950s. gradual decline in the discovery and development of new antibiotics.
In a literature review, published in 2019 in the magazine antimicrobials, the authors speak of promising signs for the discovery of this type of medication. However, they stress that changes in financial models are needed to translate scientific advances into clinically approved antibiotics.
But why is it so important to develop new antibiotics?
The evolution of drug resistance in many pathogens has led to the current antimicrobial resistance crisis. Health experts warn that we are entering a was post-antibiotic, in which drug-resistant “superbugs” threaten our health and economy.
It’s a natural event. Genetic mutations occur, leading bacteria to adapt to changes in the environment, such as the presence of antibiotics. With these changes, the bacteria become stronger and more resistant.
These “superbugs” are of particular concern in hospitals, nursing homes and health centres. A study published in January last year in the magazine The Lancet estimated the annual global death toll due to antibiotic-resistant bacteria at 1.27 million.
You would think that the most obvious solution is to produce more antibiotics, right? The reality is not that simple.
“THE pipeline of new antibiotics has dried up considerably since the early 1990s, and the number of pharmaceutical companies investing in antibiotic research has declined,” says infectious disease clinical coordinator Andrea Pallotta, quoted by Cleveland Clinic.
Big Pharma’s inaction
There are several reasons why pharmaceutical companies are not investing as much in producing new antibiotics.
One of the main reasons is that antibiotics are considered low-return drugs. They are usually given for short periods of time, whereas drugs for chronic conditions such as diabetes or high blood pressure are taken for longer periods.
Furthermore, most antibiotics are sold at low priceswhich means that companies are unable to recoup their investment in research and development.
Another reason is that most antibiotics target specific bacteria, which means the market for these drugs is smaller than for other types of medication. Additionally, over the years, bacteria have developed the aforementioned resistance to existing antibiotics.
Research and development for new antibiotics is also considered more complex and costly than for other types of medication. For example, clinical trials for new antibiotics involve the use of patients with severe infections, which is more complex and expensive than tests for other types of drugs.
Regulatory criteria for approving new antibiotics are also typically stricter than for other types of medication.
There is still a lack of government incentives for the research and development of new antibiotics. There is little funding and no additional financial incentives for companies that develop new antibiotics.
In the United States, innovation in antibiotics has stalledwrite to WIRED. The last new class approved by the Food and Drug Administration (FDA) debuted in 1984.
A light at the end of the tunnel?
Fortunately, there are still some initiatives to try to stimulate the demand for new antibiotics, including the creation of financial incentive programs for companies that do.
The call Pasteur Law is ready to be voted on by the US Congress. The bill promises secure federal funds to help a small number of antibiotics get to market. The proposal has bipartisan support in the House and Senate, and is supported by the Department of Health and Human Services.
In its current form, the Pasteur Act provides 6 billion dollars, over several years, to build a kind of signature plan for the development of new antibiotics. THE The New York Times speak in a “Netflix model”.
Basically, the law would do away with the conventional model that links antibiotic profits to sales volume, creating a subscription plan that would provide pharmaceutical companies with an upfront payment in exchange for unlimited access to an FDA-approved drug.
“If we want antibiotics to work for our children, our grandchildren or ourselves in ten years’ time, we have to invest in the infrastructure today,” Kevin Outterson, CEO of CARB-X, a nonprofit organization, told the US newspaper. for-profit organization that funds companies that develop new antibiotics.
Pasteur law is not the cure
Not everyone welcomes the eventual approval of the Pasteur Act. Critics argue that the bill is a kind of gift to the pharmaceutical industry is that it is unlikely to solve the problem of antibiotic resistance.
In a letter sent to Congress, opponents suggest that the law would encourage the development of ineffective drugsin part due to what is said to be a flaw in the FDA’s antibiotic approval process.
Under FDA directives, new drugs can be approved under a concept that allows new drugs to be less effective than existing ones.
“According to the Pasteur Law, taxpayers’ money will be wasted like a blank check for pharmaceutical manufacturers of limited benefit antimicrobials”, reads the missive.
“As a physician, it is a huge concern for me that we could have expensive new drugs on the market without regulatory oversight to really ensure that these drugs are clinically meaningful or that they even address resistant infections,” said Reshma Ramachandran, a professor at the University School of Medicine. from Yale.
The executive director of global health at the International Federation of Pharmaceutical Manufacturers and Associations is also concerned.
“The Netflix analogy is good because in a few months you can delight yourself with a bunch of episodes. Whereas at other times, you know, it’s summer, you’re out, you don’t see anything, but you still pay your subscription.” marketplace.
Daniel Costa, ZAP // 
