Contagious Disease Innovation

Tackling Antimicrobial Resistance

O’Neill Commission has identified a number of recommendations to tackling drug-resistant infections. Seth Seabury and Neeraj Sood have their own thoughts on how to incentivize the development of antibiotics to fight antimicrobial resistance (AMR) which they describe in an interesting article in the Health Affairs blog. They write:

The US patent system incentivizes innovation by offering the creator of a new technology monopoly power over its use for a fixed period of time… In the case of medications , we would thus expect market forces to give manufacturers incentives to invest in the development of new treatments [covered by patents] that offer the most value to patients (Note 1).

However, while the development of new antimicrobials to combat AMR would seem to offer high value, our current system offers insufficient incentives to invest in them. This is because the profit from a new drug is mechanically related to the number of people who take it. In the case of antimicrobials, more use of a specific agent eventually leads to resistance, so the highest societal value from new antimicrobials comes when they are used as little as possible until needed. This significantly undermines the incentives for manufacturers to invest in the development of a new antimicrobial drug. Efficient incentives will come from policy interventions that dampen the tie between manufacturer profits and the volume of antimicrobial use.

The authors examine a number of alternatives to incentivize the development of antibiotics including market entry awards, exclusivity extensions, priority review vouchers or some type of combined approach. Interesting throughout.

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