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Monday, February 17, 2014

The Search For New Antibiotics

Microbiologist Tatiana Travis works with tubes of bacteria samples in an antimicrobial resistance and characterization lab within the Infectious Disease Laboratory at the federal Centers for Disease Control and Prevention, Nov. 25, 2013, in Atlanta. (David Goldman/AP)

Microbiologist Tatiana Travis works with tubes of bacteria samples in an antimicrobial resistance and characterization lab within the Infectious Disease Laboratory at the federal Centers for Disease Control and Prevention, Nov. 25, 2013, in Atlanta. (David Goldman/AP)

Two drug companies, Roche Holding and GlaxoSmithKline, have announced they’ll ramp up research into antibiotics. They join a handful of other companies. This comes after pharmaceutical companies largely stopped working on antibiotics, citing high costs and little payoff.

But with drug-resistant “superbugs” killing more than 23,000 people each year, according to the Centers for Disease Control and Prevention (CDC), there have been calls for more research in the field.

Here & Now’s Robin Young takes a closer look at the search for new antibiotics with Kevin Outterson, editor-in-chief of the Journal of Law, Medicine & Ethics, who is working on this issue with public health officials in Iowa City.

Interview Highlights: Kevin Outterson

Why companies stopped investing in antibiotics

“They couldn’t make any money. Antibiotics, you know, typically are fairly inexpensive and we’re used to not paying much for them. On top of that, every time you bring out a new antibiotic, public health officials and people in hospitals want to limit the number of times it’s used. So for most businesses, that’s a pretty rough business model.”

On the misuse of antibiotics

“We should think of this as a global resource that needs to be conserved and taken care of. So antibiotics should never be used inappropriately. In the country right now, we have something on the order of 23 million people who are getting antibiotics for ear aches. Most of those situations would resolve on their own in a couple of days. We also give antibiotics many times for people just because they have some sort of a common cold — it’s estimated 18 million prescriptions a year — doesn’t help anyone who has the common cold. It’s a complete waste.”

On the rise of antibiotic-resistant bacteria

“It’s frightened people for more than a decade. You mentioned at the top the 23,000 Americans who are dying from resistant infections. The CDC said on top of that, there’s another 14,000 dying from a horrible disease, intestinal disease, called Clostridium difficile [C-diff] in the United States. Together, that’s larger than the number of people who die in this country each year from AIDS. And we’re not — as bad as things are now, the more troubling aspects, or what might happen in five or 10 years if some sort of a pathogen was resistant to everything we had got out to the population. It sounds like a Hollywood movie.”

On the idea of ‘delinkage’

“The idea of delinkage is that the companies and governments agree — and it’s a contractual measure, they would agree by contract — that the government would pay a certain amount to the company for each year or for each decade that the drug is available. And that number would not change based on the number of people that actually needed it. So it’s like buying an insurance policy but it takes the volume incentive out of the hands of the companies and instead puts it into the hands of the clinicians, the doctors… In the last farm bill, the amount of conservation-related payments over a decade in the farm bill, I believe is in excess of $40 billion. For antibiotics, $2 or $3 billion a year would have an absolutely electrifying effect in fixing this sector and protecting us from a post-antibiotic era. So the amount of money we’re talking about is really quite reasonable compared to what we spend in other areas of conservation. So this is not a subsidy; it’s a different business model to recognize the fact we need antibiotics but we don’t want them oversold.”

Guest

  • Kevin Outterson, professor of law at Boston University and editor-in-chief of the Journal of Law, Medicine & Ethics. He contributes to the blog “The Incidental Economist” and his academic papers can be seen here.

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Robin and Jeremy

Robin Young and Jeremy Hobson host Here & Now, a live two-hour production of NPR and WBUR Boston.

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