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Drug Companies Urged to Conserve Antibiotics to Fight Resistance

Pills in a prescription bottle (


A new report recommends that pharmaceutical companies take a different approach to combating resistance to antibiotic drugs. An article published today in the journal Health Affairs suggests physicians, hospitals, and drug makers coordinate their practices to extend the effective lifetimes of antibiotics.

The paper, by Aaron S. Kesselheim of Brigham and Women’s Hospital and Harvard Medical School and Kevin Outterson of the Boston University School of Law, notes that the U.S. must conserve the use of antibacterial drugs, or face a public health crisis from rapidly rising rates of antibiotic-resistant infections. Their analysis indicates that our supply of antibiotics is being depleted by resistance, which occurs when infection-causing microbes mutate or change so that they no longer respond to widely-used treatments.

To solve this problem, pharmaceutical companies today develop new drugs to replace those that are no longer working. This approach, along with the current pharmaceutical reimbursement system, say the authors, gives companies an incentive to oversell antibiotics. When combined with the practice of aggressively marketing antibiotics, these practices actually add to the resistance problem.

The report suggests devising a new system of practices and financial incentives to better combat resistance to current antibiotics, in addition to developing new drugs to replace those rendered ineffective. The authors recommend suggest that experts determine the rates of resistance and set “effectiveness targets” for newly approved antibiotics. To meet those goals, based on characteristics of the disease treated by the antibiotic such as lower resistance rates, drug companies would coordinate with physicians and hospitals so that the drugs are prescribed only when required. Such action would remove the current incentives to oversell and over-prescribe.

Incentives would need to be established that reward drug makers for meeting those goals. The authors offer as examples bonuses paid by Medicare or extensions to patents that give the companies market exclusivity. Hospitals likewise should receive incentives for practices that improve infection control.

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