We can win the war on superbugs but only with the right investment
Originally published on The Telegraph
Antibiotics are the precious pills that underpin our entire health system.
They are the foundation of modern medicine and the bedrock of the treatments we take for granted – from chemotherapy to minor illnesses.
Yet while we are often happy to accept that cutting-edge, life-saving treatments, like our most modern cancer therapies, will be expensive, the value our health systems attach to antibiotics is measly.
Low prices and unpredictable demand for antibiotics means that the pipeline of new ones is dry. No new antibiotics against the most dangerous Gram-negative bacteria have been developed since the 1960s.
Only three major pharmaceutical companies remain in the antibiotic research field – Sanofi and Novartis closed their programmes last year. Decades of medical innovation and progress risks collapsing before our eyes unless we can develop new drugs to replace the ones that no longer work because of the rise of superbugs.
The Government’s new strategy to tackle drug-resistant superbugs, published last week, reflects the UK’s continued commitment to tackling this threat within the NHS and on the global stage.
It rightfully recognises the profound threat that the emergence of superbugs poses to society, and the broad range of actions needed to counter it. Most notably, it commits to taking bold steps to work with pharmaceutical companies to get new drugs to the patients who need them.
This is long overdue. There are new drugs entering the pipeline – Wellcome is currently co-funding the development of over 40 new treatments and diagnostic tools through the CARB-X partnership, in which the UK and US Governments are also investors.
Yet these promising new innovations – almost all of them incubated in small biotechs – face a virtually impossible path to market. These small companies can take the development so far, but at present simply cannot attract the investment needed to take the costly steps required to translate discoveries into treatments.
To take these expensive, risky steps towards market, companies large and small should able to recoup their costs somewhere. Drugs are sold on a pill-by-pill basis, but any new antibiotics would be held in reserve and only used against the most serious superbugs, limiting the revenue that can be gained.
Higher prices would risk distorting the use of new products, either incentivising over-promotion or inhibiting access. The government’s new plan to pilot a subscription model, which pays developers a fee for the NHS to access antibiotics, rather than paying by volume, is exactly the sort of model that could fix this conundrum.
It provides certainty for developers about the revenues they can expect, even if their new product is held back for a handful of the neediest patients. But as a pilot alone, it does not provide a definitive answer; we will need to go further and faster to re-invigorate antibiotic development and ensure its future sustainability.
UK leadership in tackling superbugs is a great success story. The UK is showing it is ready to lead by example in this area, and hopefully other governments will now follow suit in reforming how their health systems pay for antibiotics.
This issue is already firmly on the agenda at the G20, the UN, and in capitals around the world; by committing to resource this plan fully, and showing that there is political will at the highest level to stop superbugs, the UK can ensure that these global discussions deliver concrete results.
Since the end of the second world war, we’ve relied on antibiotics as if they would never fail us. But their power is waning. To make sure we have new options available to us and our children, we must act now.
Promising R&D projects risk dying on the vine for lack of finance. By continuing as we are we don’t just risk lives, we risk the entirety of modern medicine.