Tuesday, January 30, 2018

Davos and Merck

Its Davos time again – or at least it was last week. During the Davos meeting, the final DRIVE AB report was released where pull incentives were highlighted. A report from the AMR Industry Alliance was also published focusing on the fight against resistance by industry. But at the meeting itself, almost nothing was said regarding resistance and incentives as far as I can tell by looking at the publicly available highlights for the conference.  (Needless to say, I was not there).

The AMR Industry Alliance report was interpreted by some as saying that GSK and J&J are leading the effort in the fight against resistance.  I did not interpret it that way.  The report did say that both companies are opening some of their data to public collaborations – but that does not mean they are ahead in the fight against resistance. In my own view of the industry in this regard, there are companies like Entasis with both strong clinical and preclinical efforts that probably deserve better ratings than GSK and J&J.

One clear message from both Drive AB and from the AMR Industry Alliance was that pull incentives are desperately needed and that, there, no one has seen much progress.  Yes – there has been a lot of writing in many publications, position papers, white papers. Folks like us have been talking among ourselves. My friend John Rex keeps saying that ten years ago we never dreamed we would be having these conversations - and he is right.  But in terms of concrete action – no one is seeing anything.

This brings me to Merck and the recent announcement of the spinoff of many of its preclinical assets in the antibiotic space, Prokaryotics. Wow!  This looks like a good team.  Terry Roemer is leading the science and Keith Bostian is the CEO. I invite you all to look at their website.  BUT – what does this say about Merck? To me it says that with its acquisition of Cubist and its products in the marketplace like ceftolozane-tazobactam, tedizolid and its pipeline compound, imipenem-cilastatin-relebactam, they have had it with the antibiotics space. They do not want to dig themselves a deeper hole. And without clear pull incentives, the rest of the industry is going to follow in their footsteps and of those of the Medicines Company and so many others over the last 20 years.

The AMR Industry Alliance called on all stakeholders to “move beyond statements of intent and to take concrete action to address AMR.”  Amen. Of course, it has not been like there has been no action.  We have a good deal of money for push incentives – take CARB-X as an example. But when it comes to the strategy that will be the most costly and yet is the most desperately needed, pull incentives, we are nowhere.

The antibiotics market is broken. It requires financial intervention in the form of pull incentives to assure the continued availability of new antibiotics active against ever-emerging resistant pathogens. Without this intervention we will all be stuck talking to ourselves on the deck of a very large Titanic.

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