For those of you who have not been following this story closely, the market entry rewards we have been discussing that are intended to fix the broken antibiotics market are not currently part of the Pandemic and All-Hazards Preparedness Reauthorization Act. This legislation was our best hope of getting something in the budget. I have it on good authority that we should write the following congressional representatives in this regard.
Rep. Doris Matsui (D-CA) megan.herber@mail.house.gov
Rep. Anna Eshoo (D-CA) rachel.fybel@mail.house.gov
Rep. Brett Guthrie (R-KY) sophie.trainor@mail.house.gov
Rep. Chris Collins (R-NY) charlotte.pineda@mail.house.gov
Rep. Marsha Blackburn (R-TN) meghan.stringer@mail.house.gov
Some talking points for you are included below.
The antibiotic market is broken. The problem, from the private market view, will not be addressed anytime soon. 
In the meantime, antibiotic resistance is not going away. The CDC estimates that we lose 23,000 American lives every year and $20 billion in excess costs to the problem of resistance. Most experts, myself included, believe this is a vast underestimate. The O’Neill commission in the UK estimates that globally we lose 700,000 lives a year today to resistance. They noted that if current trends continue, we will see over 10 million deaths and one hundred trillion dollars in lost GDP globally by 2050. Ultimately, we will end up in a world where simple surgery, cancer chemotherapy, wounds of war and routine medical treatment will become dangerous because of the lack of antibiotics available to treat common but resistant infections.
At the same time, investment in antibiotic research and development is at an all time low. Between 2000 and 2010 all but a few large pharmaceutical companies had jettisoned their antibiotic research efforts. In recent years, Astrazeneca, Sanofi, and J&J all followed suit. The Medicines Company and Allergan disinvested within the last year and more companies are likely to follow soon. This is mainly due to lack of market incentive to pursue antibiotic research. Private investors have heard this message and consequently private funding of biotech is in danger as well.
Even though public funding of antibiotic research has increased, there is no way to bring any resulting products to market without the participation of the private markets.
To solve this impasse, government must act. The GAIN act did not work because extending exclusivity on a non-profitable product is not an incentive. Some sort of market entry reward is required to fix the broken antibiotic marketplace and re-incentivize private investment in antibiotic research. Most experts estimate the cost of this to the US would be something like $20 billion over ten years. The consequence of not acting is too horrible to contemplate.
I am happy to discuss this with you or your staff at any time. Other experts you can contact include Kevin Outterson, John Rex and David Shlaes.
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