In an unprecedented bid to address antibiotic resistance, more than 80 drug and device makers have issued a declaration urging governments to “support investment” in developing medicines and diagnostic tools to combat drug-resistant infections.
The statement, which was released as the World Economic Forum proceeds in Davos, Switzerland, comes amid increasing worldwide concern about the inability to cope with various infections and a simultaneous dearth of new products needed to combat the threat.
Drug-resistant infections are forecast to cause 10 million extra deaths a year and consume up to $100 trillion in health care costs by 2050, according to a report released last year by the Review on Antimicrobial Resistance, a project commissioned by the United Kingdom government to study the problem.
In the United States, antibiotic resistance has been blamed for at least 2 million illnesses and 23,000 deaths annually. In late 2014, the White House released a strategy calling for specific steps to develop new antibiotics by 2020 and measures to prevent the spread of drug-resistant bacteria.
But efforts to develop new medicines and diagnostics have been at a logjam. While acknowledging the need for new products, the pharmaceutical industry has argued that sufficient incentives are lacking when resources can be devoted to such lucrative areas as cancer.
“We support the increasing recognition that the value assigned to antibiotics and diagnostics often does not reflect the benefits they bring to society, nor the investment required for their creation,” according to the statement released today.
“Therefore, we call on governments to commit to allocating the funds needed to create a sustainable and predictable market for these technologies while also implementing the measures needed to safeguard the effectiveness of antibiotics.”
The UK’s Review on Antimicrobial Resistance, in fact, attempted to address this issue last year by proposing international funding from governments and philanthropic organizations to “support blue sky science and incubate ideas” that are “more mature” and have a chance of reaching fruition.
By seeking funding commitments, industry maintains that a more “predictable” market is created. The industry is also seeking new commercial models that would lessen reliance on prescriptions to drive revenue, while also obtaining greater assurance that payers make “prompt” reimbursement decisions.
“We’ve never done this before as an industry, but we’re ready to think very differently about this therapeutic area and commercialization models that can be applied,” David Payne, a GlaxoSmithKline (GSK) vice president who heads the antibacterial business unit, told us.
“This is the first time this many companies have all aligned and declared their interest in addressing this area,” he added. And he noted that, by removing the link between product sales and prescription rates, the companies believe there would be fewer resources spent on marketing and promotion because their return on investment could come from funding.
For now, though, specifics are in short supply. Further talks will be needed in order to determine a path forward as various governments are approached to determine the sort of commitments they are willing to make in order to capitalize on industry interest.
“There’s still a lot to be figured out concerning how this would actually work,” said Allan Coukell, senior director for health programs at The Pew Charitable Trusts, a public policy organization that has worked with various groups to develop strategies for countering antibiotic resistance.
“There are big and small questions to be answered, such as where does the money come from? Some governments may negotiate reimbursement deals with specific payers. But this is certainly an encouraging step.”
He noted that investment is needed in basic science to tackle such challenges as gram-negative bacteria, for which medicines are lacking. “There are questions that aren’t being addressed by industry or academia but could underpin research and discovery,” said Coukell.
It is worth noting, by the way, that drug makers have also been blamed for antibiotic resistance by advocacy groups. They have criticized the pharmaceutical industry for promoting the use of these medicines to generate weight gain in food-producing livestock. The US Food and Drug Administration has a voluntary plan to reduce usage.
Among the many other companies to sign the declarations are some of the world’s largest drug makers, such as Merck, Pfizer (PFE), Sanofi (SNY), Johnson & Johnson (JNJ), Roche (RHHBY), Novartis (NVS), and AstraZeneca (AZN). Other signatories include Japan’s Shinogi and Cipla, a generic drug maker based in India.