Pasteur Act Can Reivigorate the Broken Antibiotic Market
By Christopher J. Burns and Ankit Mahadevia
Antibiotics have made modern medicine possible. Without them, surgeries and other routine medical procedures would be incredibly risky to conduct. In fact, antibiotics are so prevalent throughout society -- Americans fill over 260 million antibiotics prescriptions annually at the pharmacy -- that it's tough to fathom a world without them.
But we may have to start fathoming.
Bacteria and fungi are developing immunity to our current arsenal of antibiotics. Every time a patient takes these drugs -- whether for strep throat or to prevent post-surgery infections -- some bacteria may survive and multiply into stronger, more resistant strains.
Without more research and development spending that yields a constant stream of new antibiotics, millions could die in the years ahead.
The threat is already circulating among us. Each year, more than 35,000 Americans die from a drug-resistant infection. Researchers at Washington University in St. Louis believe the true annual death toll may exceed 162,000.
All Americans -- including healthy young people -- are at risk from these "superbugs." Children, cancer patients, and people over the age of 60 are at even greater risk, though. Patients with chronic conditions are also particularly vulnerable.
Antimicrobial resistance was especially apparent during the height of the pandemic. A recent study found that 50% of those who died from Covid-19 had acquired a secondary bacterial infection in their last days of life.
It's critical we have medicines capable of treating bacterial infections. When old antibiotics become ineffective, we need new, cutting-edge drugs to replace them. Yet the high-risk nature of antibiotic R&D can deter even the most hopeful investor from funding much-needed projects.
Antibiotics are only used for about a week and should only be prescribed when absolutely necessary. As a result, firms typically sell relatively few doses of antibiotics. Since more regularly prescribed medicines are more likely to return investors their money, companies do not invest time and capital in developing drugs for pathogens that are rare today -- but pose a grave threat to public health in the future.
Researchers warn that without new antibiotics, drug-resistant infections could kill 10 million people annually by 2050.
Thankfully, bipartisan minds in Congress recognize the need for new antibiotics and proposed a method to reinvigorate antibiotic research and development. Named after the famed microbiologist Louis Pasteur, the Pasteur Act would adjust the incentive structure for antibiotics research.
The bill would implement a "Netflix-style" payment model for antibiotics in which the government pays firms a fixed fee for access to their treatments. Antibiotic developers' revenue wouldn't depend solely on sales volume -- though developers would still be free to sell the medicines to hospitals and insurers. The Pasteur Act also prevents overprescribing by establishing a new grant system to support antibiotic stewardship programs in hospitals. These programs seek to improve doctors' antibiotic prescribing habits by investing in education, accountability, reporting, and tracking of antibiotic usage and resistance.
As founders and CEOs of research organizations focused on antibiotic development, we are committed to saving patients' lives. We sometimes find ourselves competing for the same investor dollars. However, we stand firmly together on this important issue -- because the solution is clear. If passed, the PASTEUR Act will boost antibiotic innovation and support the backbone of modern medicine.
We can all agree on that.
Christopher J. Burns, Ph.D., is co-founder, president, and CEO of Venatorx Pharmaceuticals. Ankit Mahadevia is co-founder and CEO of Spero Therapeutics. This piece originally ran in the Boston Herald.
