The hit is not just monetary. In an analysis also published in the BMJ, researchers say multi-drug resistant bacteria claim 25,000 lives in the EU every year.

CONVINCING COMPANIES TO FIND NEW DRUGS


In November, the EU and the United States set up a task force to look at the issue of drug-resistant germs, prompting the Infectious Diseases Society of America to call for creating 10 new antibacterial drugs by 2020, according to the BMJ editorial by Anthony D So, Neha Gupta and Otto Cars.

The trouble is convincing companies to undertake the research. A mere 1.6 percent of all drugs in development by the world's 15 largest drug companies in 2004 were antibiotics, Chantal Morel, a research fellow at the London School of Economics and Political Science, wrote in her accompanying analysis.

One reason for the low rate of development is antibiotics are often less profitable for drug companies, Morel said. For one, they cure disease instead of managing symptoms for chronic conditions over a long time, she said. Also, generic antibiotics are used for most infections, with newer ones used infrequently, often saved for tougher cases. Plus, researchers lack reliable point-of-care diagnostic methods and good models for developing antibiotic treatment studies, she said.

In her article, co-written with Elias Mossialos, a professor of health policy at LSE, Morel cites a Current Opinions in Microbiology piece showing the risk-adjusted net value of an antibiotic is only one-third that of a cancer drug, and one-tenth that of a musculoskeletal drug.

To entice companies to develop new antibiotics for drug-resistant pathogens, Morel believes governments can offer grants and tax incentives, and even require researchers working on publicly funded projects to share findings via open-access libraries to make collaborative biomedical work possible. Government groups can even look to orphan drug legislation, which provides various exemptions or incentives to researchers working on treatments for rare diseases, to see if offering limited exclusivity extensions spurs development.

"Pricing and reimbursement levels right now minimally reflect the actual therapeutic benefits or cost savings that antibiotics provide," Morel told DOTmed News by email. "The promise of higher prices goes far in luring developers to antibiotics."

IMPROVING THE CONVERSATION

While drug development would be years away, Hay hopes in the near term his work can help primary care doctors and nurses when they discuss the subject with patients.

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