Since the appearance of Jim O’Neil’s last report,
there has been a surge of international (virtually all ex-US) thinking about
how to approach the problem of antibiotic resistance. Most recently, the WHO
approved a plan to combat antibiotic resistance that included a plan to develop
a plan to support new investment in antibiotic research – if you see what I
mean. Germany,
holding the presidency of the G7 Summit this year, will introduce a plan to
provide international funds to support the development of new antibiotics to
combat resistance. Part of this plan will be to designate these antibiotics as
orphan drugs – a topic they have already raised with the European Commission
and upon which I reported recently in this blog.
All of this is nothing but good news. But I still have a
problem with seeing, in a practical way, how any of these good intentions will
turn into the effective use of dollars (or more likely Euros) as an incentive
that will attract companies (back) to antibiotic R&D. Whatever the plan is,
it must be crystal clear and must lack the usual bureaucratic intricacies of
the usual WHO and EU funding mechanisms. It must also involve large sums of
money as noted in the O’Neill report - $1-3 billion per antibiotic aiming for
around 10 new antibiotics over the next twenty years. That’s a lot of money. Of course, compared to O’Neill’s worst-case
scenario of no working antibiotics and a $100 trillion hit to the world
economy, it’s a drop in the bucket.
It seems likely that something involving actual funding will
come out of all this. How it will work in reality right now is anyone’s guess.
If I were a pharmaceutical company who was not active in antibiotic research today, I would be making plans to be there tomorrow. A couple of companies that come to mind are Vertex and Gilead – especially Gilead.
Vertex has dabbled in antibiotic research in the past and finally gave up the ghost several years ago. Bad timing in my view – but, given their lack of productivity, maybe it was not the wrong decision at the time. Maybe now is the time to rethink.
With the entry of Gilead’s high-priced
drugs for Hepatitis C to the market place over the last two years, their
earnings have soared. Analysts and
investors are asking
how Gilead will be able to continue to grow?
Will this require an acquisition?
And if this were to occur – in what area of pharmaceuticals should it
focus? Well Gilead, here is your answer
– antibiotics. Of course, this is not so easy since the only large antibiotic
franchise that might still be available for “partnering” if not a complete
takeover is that of AstraZeneca. But with their pipeline around the novel
B-lactamase inhibitor avibactam, this would be attractive. That is, it would be attractive if
AstraZeneca is reasonable in its demands. Of course, AstraZeneca could do with
some rethinking as well, as I have been saying for the last two years.
So, I remain skeptical that organizations like the G7, the
EU and the WHO can actually get their acts together to come up with the kind of
monies we are targeting. And importantly, a clear pathway to those monies must
also be provided. Nevertheless, I believe that something good will happen in
the near future. This is not the time for indecision in the industry. This is the time for bold, pre-emptive action
such that you are positioned to take advantage of the coming opportunities.
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