Past, Present, and Future of Antibacterial Economics: Increasing Bacterial Resistance, Limited Antibiotic Pipeline, and Societal Implications
Past, Present, and Future of Antibacterial Economics: Increasing Bacterial Resistance, Limited Antibiotic Pipeline, and Societal Implications
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DOI：
10.1002/phar.1868
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发表时间：
2017-01-01
期刊：
影响因子：
4.1
通讯作者：
Mohr, John F., III
中科院分区：
文献类型：
--
作者：
Luepke, Katherine H.;Suda, Katie J.;Mohr, John F., III
抗生素耐药性的增加和抗生素管道的减少导致了一个新兴的后抗生素时代，因为患者现在死于曾经可以治疗的细菌感染。从20世纪40年代开始的抗生素开发的快节奏黄金时代已经失去了动力;从20世纪80年代到21世纪初，新抗生素的批准下降了90%，并且发现了一些新的新类别。由于科学、监管和经济方面的障碍，许多公司已经放弃了抗生素的开发，这些障碍证明，与利润更丰厚的治疗领域相比，抗生素的开发吸引力较小。国家和全球的努力正在将注意力集中在重振抗生素管道的潜在解决方案上，包括公私伙伴关系等推动激励措施和报销改革和市场排他性等拉动激励措施。混合激励模式、利益相关者之间的全球协调以及抗生素定价、药物使用量和适当的抗菌药物管理的适当平衡是最大限度地努力开发药物以确保有需要的患者获得这些治疗的关键。
Growing antimicrobial resistance and a dwindling antibiotic pipeline have resulted in an emerging postantibiotic era, as patients are now dying from bacterial infections that were once treatable. The fast-paced Golden Age of antibiotic development that started in the 1940s has lost momentum; from the 1980s to the early 2000s, there was a 90% decline in the approval of new antibiotics as well as the discovery of few new novel classes. Many companies have shifted away from development due to scientific, regulatory, and economic hurdles that proved antibiotic development to be less attractive compared with more lucrative therapeutic areas. National and global efforts are focusing attention toward potential solutions for reinvigorating the antibiotic pipeline and include push incentives such as public-private partnerships and pull incentives such as reimbursement reform and market exclusivity. Hybrid models of incentives, global coordination among stakeholders, and the appropriate balance of antibiotic pricing, volume of drug used, and proper antimicrobial stewardship are key to maximizing efforts toward drug development to ensure access to patients in need of these therapies.