Nat geo jan 22

The National Geographic Society

Pharma Industry Calls on Governments to Fund New Antibiotics – Phe... http://phenomena.nationalgeographic.com/2016/01/20/davos-declaration/

1 of 20 3/14/2016 11:20 AM


2 of 20 3/14/2016 11:20 AM


3 of 20 3/14/2016 11:20 AM


4 of 20 3/14/2016 11:20 AM

A Blog by Maryn McKenna

BLOGGERS


5 of 20 3/14/2016 11:20 AM

Governments must help solve the problem of no new antibiotics by funding and creating

incentives for developing new drugs, almost 100 pharmaceutical companies and trade

associations say in a statement being released this evening at the World Economic Forum

in Davos.

“The value assigned to antibiotics and diagnostics often does not reflect the benefits they

bring to society, nor the investment required for their creation,” they say. “We call on

governments to commit to allocating the funds needed to create a sustainable and

predictable market for these technologies while also implementing the measures needed

to safeguard the effectiveness of antibiotics.”

The Declaration by the Pharmaceutical, Biotechnology and Diagnostics Industries on


6 of 20 3/14/2016 11:20 AM

Combating Antimicrobial Resistance commits the companies—which include both the

largest, such as Merck & Co. and Pfizer Inc., and many small biotech firms and makers of

diagnostic devices—to a common set of global actions to combat resistance. Those include

reducing overuse, encouraging the development of diagnostic devices that can keep the

drugs from being overused, and conserving antibiotics in a manner generally called

“stewardship”—which, by keeping critically needed drugs on the shelf, can cut into

company profits. And it calls for governments and others funders to join the companies

in pursuing new drugs to solve what’s known as the “pipeline problem.” That is the

difficult reality that antibiotics manufacturers practically abandoned the field after about

2000, because the relatively low retail prices of their drugs (compared to cancer drugs, for

instance), coupled with the advance of antimicrobial resistance, turned making

antibiotics into an unrewarding move.

Since the Infectious Diseases Society of America flagged the problem of “bad bugs, no

drugs” in a revelatory report 12 years ago, policy makers have argued over how best to

lure drugmakers back into the market, proposing price hikes, patent extensions, prizes,

up-front payments, and a variety of other incentives. What should be offered to

companies to bring them back is a matter of intense debate, captured in this issue brief by

the Center for Disease Dynamics, Economics and Policy and this Chatham House

analysis by Kevin Outterson of Boston University. The issue is at the heart of three pieces

of legislation, the GAIN Act of 2012, the ADAPT Act of 2013, and the PATH Act,

introduced in the current Congress. Last summer, the Review on Antimicrobial

Resistance, a two-year project created by UK Prime Minister David Cameron

to investigate solutions to the global crisis, proposed a program of supports for innovation

and early-stage research, and also mammoth payments that would effectively free a

company from having to earn its investment back via sales.


7 of 20 3/14/2016 11:20 AM

The declaration made this evening (Thursday morning, in Europe) will be housed on the

site belonging to the Review on Antimicrobial Resistance — but its chairman, economist

Lord Jim O’Neill, said in an interview that it should not be construed as the Review’s

work. “This is a statement coming from industry,” he told me. “We are pleased to see it

happen. But our own final recommendations, which are 4-5 months off, may differ. Part

of their declaration is a call to governments to give them the incentives they want. But

it might well be that in the range of recommendations we make will be that the industry

itself may have to make significant contributions.”

The declaration does not specify which incentives the industry prefers to receive, though

it mentions the lump-sum purchases examined by the Review, technically called market

entry rewards; “insurance-like purchase models”; and enhanced intellectual property

protections. It also does not mention any numbers. But it suggests increases in

reimbursement for antibiotic and diagnostic-device purchases—while being careful to

mention that entities should not be rewarded “for prescribing of antibiotics in greater

volumes” (which would raise company income but increase the risk of resistance).

Dr. John Rex, a senior vice president and chief strategy officer at drugmaker AstraZeneca


8 of 20 3/14/2016 11:20 AM

Inc. and one of the strategists behind the declaration, told me:

“The irresolvable tension is, if we prevent the spread of resistance, we won’t use the drugs

very much. And if the revenue to the manufacturer depends on sales for use to

treat infections, the manufacturer doesn’t have any revenue, doesn’t recoup costs and

can’t maintain its supply chain. So I come back to two fundamental questions: What is

antibiotics’ value, and how should we buy them?

“As a metaphor for value, I think of the fire department. We are surrounded by

fire-prevention services: smoke detectors, fire stations, firemen, the water supply. Most of

us never have the misfortune of needing them, but in a very real sense we use them every

day. You would not stop paying for them because you haven’t used them; at the end of the

year, you are delighted not to have. Antibiotics in the hospital are like the fire department.

They have a value when we treat an infection, but they have a bigger value when you know

that you could use them to treat an infection if you needed.”

But how that value is to be priced, and what the mechanisms will be, “will be a project of

some years,” Rex said, adding that some incentives will work better in different

economies or jurisdictions than others. “I’m looking at the operational goal,” he said.

“You don’t start setting up the fire service when the building is already on fire.”

Early reaction tonight to the declaration was enthusiastic but cautious. Ramanan

Laxminarayan, the founder of the Center for Disease Dynamics, Economics and Policy

—which argues that incentives for new drugs should take a back seat to programs to

conserve existing ones—told me by email: “This is a big moment, and a recognition by

industry of the huge role they play in conserving the effectiveness of antibiotics we have

and in the development of the drugs, vaccines and diagnostics we need. But resources

allocated to these needs are still too small, and need to match the scale of the

antimicrobial resistance challenge.”

At the Pew Charitable Trusts, which operates projects on antibiotic resistance and

innovation, senior director of health programs Allan Coukell said: “Antibiotic resistance is

one of the pressing public health issues of our time. This declaration, with its long list of

industry signers, affirms not just the need to tackle the scientific and economic barriers to

drug development, but the importance of conserving the antibiotics we have today.”


9 of 20 3/14/2016 11:20 AM

Previous posts:

Dec. 7, 2015: “Proposal: Set International Targets for Farm Antibiotic Use“

Sept. 9, 2015: “Can Offering a $12 Million Prize Make a Difference to Drug

Resistance?“

May 23, 2015: “We Need Antibiotics. They’re Not Profitable to Make. Who Pays?“

Feb. 5, 2015: “How to Fight Superbugs: Start Spending Money“

Dec. 15, 2014: “The Coming Cost of Superbugs: 10 Million Deaths Per Year“


10 of 20 3/14/2016 11:20 AM


11 of 20 3/14/2016 11:20 AM


12 of 20 3/14/2016 11:20 AM


13 of 20 3/14/2016 11:20 AM

It looked like the sun was erupting during last week's solar eclipse.


14 of 20 3/14/2016 11:20 AM

by Nadia Drake

Amber gives us a detailed look at the oldest chameleon yet found.

by Brian Switek


15 of 20 3/14/2016 11:20 AM

The terrifying 'drop bear' is an urban legend, but Australia really was home to a koala cousin that wasnot so cuddly.

by Brian Switek


16 of 20 3/14/2016 11:20 AM


17 of 20 3/14/2016 11:20 AM

Embed View on Twitter

Tweets by @marynmck

1h

2h

this package is the greatest thing.

twitter.com/verge/status/7…

scored the @glossier phase 2 set.

day, accomplished.

Maryn McKenna Retweeted

Maryn McKenna

@marynmck

Maryn McKenna

@marynmck

Virginia Hughes


18 of 20 3/14/2016 11:20 AM

National Geographic

GeneralShopContact


19 of 20 3/14/2016 11:20 AM

Follow Nat Geo


20 of 20 3/14/2016 11:20 AM

Documents

Nat geo jan 22