Antibiotics: urgent calls for global payment pot

By Fiona BARRY contact

- Last updated on GMT

Overreliance on antibiotics in farming has contributed to the problem of antimicrobial resistance
Overreliance on antibiotics in farming has contributed to the problem of antimicrobial resistance

Related tags: Antimicrobial resistance, Pharmaceutical industry, Pharmacology

As World Antibiotics Awareness Week draws attention to the threat of resistance, pharma companies large and small say a worldwide overhaul of payment models will make anti-infective R&D profitable again.

On Monday, AstraZeneca published an open letter in the Financial Times,​ calling on the UK government to attract companies to antibiotics discovery work with a more profitable funding mechanism.

Beyond the terrible human cost, if we fail to act now, antimicrobial resistance is also expected to cost the world economy $100tn a year by 2050,​” said the drug company. The letter was also signed by employees of King’s College, London, Antibiotic Research UK, the Royal Pharmaceutical Society, and the UK Bioindustry Association (BIA).

Fund would pay $2-3bn per drug

While antibiotics resistance grows – partly because of the overuse of anti-infectives in farming and human medicine – the pharma industry has been reluctant to sink funds into what it perceives as a poor return on investment. Traditional payment models – where companies profit per volume sold – are a weak incentive in an area where prescription levels are deliberately limited to prevent resistance.

As the UK government’s May report on antimicrobial resistance​ explains, “given that it is difficult to predict the rise of drug resistance, a useful drug for the future may come to the market when there is not yet large demand because other cheaper drugs are still effective.

“If a new antibiotic is used when dictated by resistance to alternative drugs, its patent may well have expired before it is needed in large quantities, meaning that the developer cannot make the level of financial return they need to.​”

The review team, chaired by Lord O’Neil, is due to make final recommendations in early summer 2016. At the Financial Times and BioInfect conferences in the last week, O’Neill expanded on the review’s proposal for a global innovation fund for antibiotic research, in exchange for guaranteed payments to drug companies.

Documents so far​ suggest a shared pot funded by countries – possibly the G20 – “to establish a mechanism to purchase the global sales rights to new antibiotics, and to subsequently manage their supply internationally.

The development and manufacture of drugs would still take place within the pharmaceutical industry, drawn through the pipeline by the incentive of a full ‘buyout’ of their product once it is ready to market. Although the developer would surrender the right to market their new drug, they would be reimbursed by an amount sufficient to ensure an adequate return on their development costs, and the investment incurred.​”

$2-3bn (€1.9-2.8bn) would be a “reasonable buy-out​” for a single antibiotic, said O’Neill, and could go higher if it targets critical needs.

‘Leadership needed’ from ABPI, PhRMA

Neil Murray, CEO of UK drug company RedX Pharma, says his company, with a staff of sixty, has one of the largest antibiotics discovery groups in Europe – a fact that reflects the unpopularity of this therapy area. “Large pharma is backing off,​” he said, but will return if the big players can agree on a funding model that works for everyone.

Right now the industry doesn’t talk with one voice. The ones still involved in antibiotics research –GSK, AstraZeneca, and Roche etc. – each have their own view about what that commercial model should be.

Unless the industry reaches agreement, companies risk having an unpopular or unworkable model imposed on them, he said. “So there needs to be leadership, particularly from ABPI [Association of the British Pharmaceutical Industry], EFPIA [European Federation of Pharmaceutical Industries and Associations], and PhRMA [Pharmaceutical Research and Manufacturers of America]. If we have some degree of consensus […] we can at least start with a model that can be tweaked.​”

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