A Broken Market in Antibiotics
Written by Editor   
Monday, July 07, 2014 04:53 PM

The drugs don't work - and neither does the market, when it comes to antibiotics.

When sophisticated bugs that medicines used to kill within days start to fight back and win, all of healthcare, and the people it keeps alive, is in trouble.

It's a glimpse of what Britain's chief medical officer Sally Davies calls the "apocalyptic scenario" of a post-antibiotic era, which the World Health Organisation says will be upon us this century unless something drastic is done.

Waking up to the threat, governments and health officials are getting serious about trying to neutralize it. It may seem like a question of science, microbes and drugs - but in truth it is a global issue of economics and national security.

The debate moved to center stage last week when British Prime Minister David Cameron launched a global review of the crisis, securing specific support from U.S. President Barack Obama and German Chancellor Angela Merkel.

That builds on a resolution passed at the World Health Assembly in Geneva in May recognizing the pressing need for the world to act in the fight to combat increasing resistance.

"We have to find something that works for the world."

What this demands, according to academic and industry experts, is a new business model that rewards drug firms for developing new antibiotics even if they are rarely used.

It is no accident that Cameron chose a big-hitting economic brain - former Goldman Sachs chief economist Jim O'Neill - to head the review.

"This is...not a science issue. This is an issue of markets and economics," said Davies. "A scientist would just get bogged down and not get it."

In recent decades, drugmakers have slashed investment in antibiotics because of poor returns from a class of low-priced medicines that are only used for short periods, even as overuse of existing drugs has spurred the spread of resistance.

And self-interest comes into play as well: A post-antibiotic world would undermine sales of important drugs to fight cancer or prevent rejection after organ transplants, since these medicines cannot be given without the safety net of effective antibiotics for treating potentially deadly infections.

It is clear, however, there is no simple solution - and some experts fear veering too far from free market forces will create perverse incentives that could result in taxpayers' money ending up in shareholders' pockets with meagre benefit to society.

Jeremy Farrar, head of the Wellcome Trust medical charity which has made antibiotic resistance a top priority area for research funding, sees an analogy with the defense industry.  "This is a national security issue because of what it would do to the whole of medicine and health - and governments are just going to have to step in," he told Reuters.  "The government doesn't design a tank, but it does promise to buy one if you build it to certain standards and specifications. There are lessons to be learned in the antimicrobial world and the pharma sector from other industries which governments just have to have, and have to fund."

Source:  http://www.reuters.com/article/2014/07/06/us-health-antibiotics-insight-idUSKBN0FB0A220140706