Why is the antibiotic market broken?
The current economic model for developing new antibiotics is failing. Companies invest huge amounts of money to bring a new drug to market but cannot recover their costs or make a profit.
"This is the only field within pharmaceutical science where you come out with a drug and you don’t want it to be used too much," explained Anand Anandkumar, CEO of Bugworks, a biopharma start-up dedicated to discovering new antibiotics.
New antibiotics are seen as ‘drugs of last resort’ against dangerous bacteria. So, to limit the development of antibiotic resistance, they need to be used sparingly – and not sold in large volumes. Plus, compared to more expensive treatments, antibiotics tend to be quite low in price.
The combination of low sales and low prices limits the amount of money companies can make. Without financial incentives, many large pharmaceutical companies have started to pull out of the field. In the 1908s there were 18 multinational companies committed to antibiotic research; today there are only a handful.
Antibiotic R&D is now primarily driven by small biotechnology companies. In recent years, they have made some exciting scientific breakthroughs.
Many have been funded through initiatives such as CARB-X – a partnership between governments and philanthropic organisations like Wellcome – through what is called ‘push’ funding.
A scientific breakthrough doesn’t guarantee success though, as much more funding is needed to see drugs through the expensive process of clinical trials, registration and coming to market. Once companies lose early-stage funding, it becomes much more difficult to find investment.
And bringing a drug to the market doesn’t guarantee success either, as the bankruptcy of biotechnology companies like Achaogen and Melinta Therapeutics shows.
The question of how to make antibiotic research and development sustainable remains.