Industry subscription service could spur research for antibiotics, expert says – EURACTIV.com


A “Netflix-style” subscription service, regularly paid by governments to the pharmaceutical industry, could help spur the creation of much-needed new antibiotics and shatter the “toxic” environment for research and development. development of antibiotics, according to an expert.

Antimicrobial resistance (AMR) is the ability of microorganisms to evolve to resist antibiotics, making infections increasingly incurable.

AMR kills up to 33,000 in the EU each year, but this is expected to worsen dramatically as AMR is poised to become a bigger killer than cancer by 2050.

However, despite the looming threat of this so-called “silent pandemic,” the research and development of new antibiotic treatments is toxic, according to Jeremy Knox, policy and advocacy manager on the Wellcome Trust’s Drug Resistant Infections Priority Program. , a charitable foundation focused on health research.

“The market is very unpredictable and generates very low revenues, which has led to decades of divestment by pharmaceutical companies,” Knox told EURACTIV, noting that unlike other newly developed drugs, newer antibiotics are not not made to be used, but to be retained only in an emergency.

That left only a small handful of large global pharmaceutical companies still in the RAM game, he said, while others have instead chosen to change their business model to focus more on the areas. low risk.

“[Companies] start with a small market, and then you capture a fraction of that small market. So it’s kind of a toxic environment, ”he said.

This has created a situation where there are “increasing rates of resistance, with existing drugs becoming increasingly undermined by these increasing rates of resistance, but really too few products in the pipeline,” Knox said, noting that it ‘had been the case since the 1980s.

Breaking this cycle of underinvestment and scientific hurdles will be extremely difficult and will require revolutionary new approaches, according to Knox.

Above all, governments must find a way to generate predictable revenues large enough to offset the investment costs of all advanced stages of research and development (R&D) until they are ready to enter the market. he declares.

One way to do this is to pay an initial lump sum for products that meet defined criteria.

Another possible avenue worth exploring is the idea of ​​a “Netflix-style” subscription service, he said, adding that this more “nuanced” approach has gained momentum in recent years. years.

In this way, governments would agree to regularly pay a fixed sum of money to support the industry, regardless of the number of units of antibiotics sold.

This type of subscription can create “stable and reliable income regardless of the amount or amount of antibiotic used,” breaking the business cycle of paying per pill, he said.

Such contracts could be awarded for 5 to 10 years, he suggested, with governments committing to pay an annual lump sum tied to the value of an antibiotic.

This can be seen as a “win-win” for all parties, Knox said, as developers would have “certainty as to the revenues they will generate and the demands they will face” while governments can “apply. good stewardship, there is no incentive to abuse the product, and they have the confidence that they will have fixed costs for years to come ”.

Although the idea is relatively new, he pointed out that this idea is currently being tested in the UK and the US is also considering the possibility of such a subscription service.

There is also growing interest in such a model in the EU, with Swedish MP Jessica Polfjärd recently citing it in a recent interview with EURACTIV as an example of how RAM’s business models could be more sustainable.

Translating this to the EU, however, could be a struggle, as Nathalie Moll, Director General of EFPIA, pointed out during a recent event on the fight against AMR,

“We’re seeing national prescription models, kinds of subscription models like the Netflix models in the UK and Sweden that seem to work in the US, but we need things that work for us here in Europe, because we are not one country, ”she said. warned.

However, one thing all stakeholders were clear on is that there is no time to waste on fixing the problem.

“We cannot wait. We need to get on with it now, ”Moll said, adding that initiatives such as the AMR fund, a $ 1 billion facility aimed at overcoming technical and financial hurdles in antibiotic development and ensuring a sustainable pipeline of new antibiotics to fight superbugs, is simply a “bridge” while waiting for longer-term solutions.

[Edited by Zoran Radosavljevic]


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