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Antibiotic resistance: what does it mean for Pharma?

Posted on: 19 Sep
Antibiotic use has transformed our society since the invention of penicillin. A relatively new medical invention, antibiotics have paved the way for better healthcare around the world, removing the threat of infection from our lives. Millions of us use them every day, to recover from operations, tackle colds and far more besides. Without them, our chances of survival would be pretty low.

However, this might become a real possibility within the next few decades. Antibiotic resistance has become a worrying problem for the medical industry in recent years; indeed, alongside lives, the World Bank estimates it could cost the world economy $1tn every year after 2030. With such huge ramifications, antibiotic resistance could affect billions of us, but at the moment it may well have the biggest impact on the Pharmaceutical companies currently producing the antibiotics that we all use.

Pharma’s relationship with antibiotics has fluctuated over the years. In the past, tens of new medicines were being released every year- however, only two new classes of antibiotics have been introduced within the last forty years, and only twelve antibiotics have been approved since 2000. Today, only two of 28 new antibiotics that are in development have ‘adequate stewardship and access provisions in place’, according to the British Medical Journal, and this is starting to have an effect, with multiple cases appearing of antibiotic-resistant infections which have, in some cases, killed patients.

What does this mean- and what ramifications does it have for the industry? 

The current situation

Many Pharmaceutical companies operate a for-profit R&D department which conducts research into new strains of antibiotic in order to patent and sell them on the market. However, many companies, including Novartis, AstraZeneca, and more- are closing their research into antibacterial and antiviral areas, citing a lack of profits and dwindling returns for their efforts. The costs of trials are high, and this makes returns small, and development expensive.

How is this sustainable in the long-term? Firstly, many new antibiotics are actually developed by small companies, which are later acquired by big pharma companies, who possess the knowledge, the network and the infrastructure to conduct thorough clinical trials and then bring the drug out into the market. Though the withdrawal of many of these big companies from the sector will decrease the number of new drugs brought out into the market, it’s also true that these small companies will continue to innovate and develop new antibiotics in the meantime. 

In addition, there are still antibiotic-resistant drugs circulating within the market. However, they are almost always used as a weapon of last resort by the doctors prescribing them. Unlike common antibiotics, for which several resistant strains of bacterium exist, rarer drugs are only used sporadically, which creates a much smaller market for them- and thereby, smaller profits. 

New options

Despite the market’s reaction, superbugs do pose a significant threat to the future of our health. Patients using prescription drugs and antibiotics incorrectly- a recent report revealed that 1 in 5 antibiotics have been prescribed incorrectly by the doctors- have led to a rise in resistant-strain bacterium, exacerbated by the use of antibiotics in agriculture and meat production. Without the proper research, this may well cause a lot of problems in the future, and to that end, companies are already starting to innovate to prevent this.

One such example involves combining antibiotics, which the European Molecular Biology Laboratory have already been doing. Testing combinations of more than 3,000 different antibiotics, they found that some combinations were proven to be more effective than regular antibiotics when delivered separately. Alongside that, researchers are also placing greater emphasis on probiotics, and on bringing back bacteriophage therapy, which uses viruses that infect bacteria to fight the bacteria themselves, once the virus itself has been purified for human consumption. Widely cited as an alternative to antibiotics, it’s been famously used in several high profile cases in the past few years and could yet be the key to treating patients in the future. For now, though, it remains an expensive and complex procedure.

In addition to this, regulators and policy-makers are taking steps to defuse a potential future crisis, removing some of the barriers in place to creating new antibiotics. In 2016, the government also produced the O’Neill report, which proposed new measures to tackle antibiotic resistance, including new models of payment to create an incentive for Pharma companies, as well as a £10m fund for companies that can develop a method to tell apart viral and bacterial infections. 

Looking to the future

We all have our part to play in the fight against bacteria. Biotechnology firms, generics manufacturers- which produce most of the antibiotics we consume today- and Pharmaceutical firms all need to tighten controls and increase transparency in order to reduce the amount of unnecessary antibiotics we take, and work towards developing a viable solution. For the person who finds the key, rising demand could be a valuable incentive- as well as more relaxed government regulations.

One thing is for sure: if we don’t commit now it will certainly be a bigger problem in the years to come.

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