Pipeline for antibiotics is running dry

STLtoday.com ^ | 1-11-04 | Tina Hesman

[FairWitness]

A dramatic shortage in the number of new antibiotics could create a public health crisis soon, infectious disease experts warn.

Major pharmaceutical companies have abandoned or scaled back research and development of drugs that kill bacteria in favor of anti-viral drugs, such as those to combat HIV, and medicines for chronic conditions, such as high blood pressure and heart disease.

[FairWitness]

See also this previous story:

Antibiotics 'close to being useless'

Suppose a drug costs $800,000,000 to develop, and you only need 8 pills per patient (realistic for an antibiotic, and makes the math easy) to cure an infection, and "only" 10,000,000 patients may need the drug. Then you need to charge $10/pill to break even and probably at least $15 to make it worthwhile overall. But the public says $15/pill is obscene and exhorbitant, and we must control the drug industry to stop its profiteering. What to do?

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[sgtbono2002]

Follow the money, The drug Companies make whatever is most profitable.

[FairWitness]

Follow the money, The drug Companies make whatever is most profitable.

Yes, because even the rich drug companies have finite resources (I was in pharmaceutical R&D for 27 years - resources were never "generous" for any one project unless it was already a sure winner). Far better to go after a "chronic" disease where your patient will need a daily dose for the rest of his/her life than to develop an antibiotic for which you can only sell 5-10 days worth of doses per patient.

[ModelBreaker]

Suppose a drug costs $800,000,000 to develop, and you only need 8 pills per patient (realistic for an antibiotic, and makes the math easy) to cure an infection, and "only" 10,000,000 patients may need the drug. Then you need to charge $10/pill to break even and probably at least $15 to make it worthwhile overall. But the public says $15/pill is obscene and exhorbitant, and we must control the drug industry to stop its profiteering. What to do?

Reduce the $800,000,000 number. That's the problem. The FDA is a classic case of the regulatory agency owned by the regulees. The FDA has erected huge barriers against competition with the companies it regulates (the big drug companies) by making it so expensive to get approval for new drugs. Executives from the industry regularly become FDA guys and vice versa.

If you don't have the resources of an Eli Lilly, forget about playing as a pharmaceutical comapny. Small companies are forced to conclude licensing deals with the Lillys to get the drug thru the approval process.

Is it any wonder that a government sponsored oligopoly does not respond to real demand?

What's sad is that our industry here is still better than in countries with socialized medicine. There, all profit incentive has been removed from drug discovery. There, the only pharmaceutical issue is distributing drugs invented in the US.

So the problem outlined in the article is a problem for the whole world. When the US companies stop making new antibiotics, the whole world will suffer because noone else is doing it. As a friend of mine says "after vanomycin, it's 1930."

[CanadianLibertarian]

If we had not got caught up in hysteria over AIDS, instead of putting obscene amounts of money into this non-issue of a disease (for most mainstream Americans) - we could have been developing new antibiotics.

Fifteen billion for AIDS in Africa? Countless billions in the U.S. to save fringe elements of society such as gays and druggies, at the cost of not developing antibiotics for the whole of society? How many millions of lives are the homo-fascists going to end up costing society?

[FairWitness]

If we had not got caught up in hysteria over AIDS, instead of putting obscene amounts of money into this non-issue of a disease

The only possible upside to the disproportional spending on AIDS (a highly preventable disease) is that it might teach us something about curing other viral diseases.

[Nowhere Man]

Almost this time last year, well February of 2003, I was in hospital due to my left hand getting cut sround the pinky up grabbing something while slipping on the ice getting out of my car. It got infected with strep. I had to have surgery and a hospital stay for 5 days. I have a nice, big scar on my hand, numbness and some nerve damage. I was lucky to get away with that because it was possible I could have had part or all of my hand amputated. My aunt had a staph infection in her foot from a cortisone shot in 2002.

I remember in the 1970's they were concerned that the overuse of anti-biotics could cause disease resistant strains which would be a problem down the road and it looks like we are there now. I think we have ap roblem where the drug companies advertise where they say "if you have this (or may have this) go to your doctor and ask him for these pills." I think instead of a patient asking for something, except in extreme cases, the doctor should be the one to make that decision. I guess we might see a time we might have to go back to sulfa-drugs like we did in the 1930's.

[waterstraat]

good article

[TASMANIANRED]

You can't expect a company be it drug or any other industry to work for nothing just like you can't expect a person to work for nothing.

The politicians, the elitist in academia, the leftist news howls constantly about obscene drug profits.

Why research anything that is going to be a revenue drain once it is developed.

John Galt wouldn't.

[gaijin]

marking

[waterstraat]

John Galt would not have lobbyied congress to exclude himself or his industry from free trade. He would not have passed laws that made his drugs more expensive in the United States than anywhere else in the world.

Galt would not have wanted to subsidize Canadian consumers and charge american citizens more to pay for the Canadians.

Rearden did not lobby congress to get laws passed to charge different prices for his steel in different countries. If you dont believe me, then read the book again.

[Billthedrill]

"With antibiotics, the more you use it, the faster you loose it," Storch said.

It's "LOSE," dagnabbit! Peeing-against-the-hurricane BTT.

Note that there have been "only" two new classes of new antibiotics since 1998. That's actually a pretty large number given that there are only a finite way of killing the little buggers without killing the patient. But the reason there wasn't an emphasis on antibiotic research was that (1) it's expensive, and (2) in order to be justified there'd have to be a need that was unmet by current therapeutics, and (3) there wasn't. At least until necrotic fascitis came along.

So now we're a little behind the power curve. The worse the problem gets, the more funding will be directed that way - it's a cold, hard calculation but the market rules here because even in such a regulated industry there's so much money involved in ramping up to production. One problem is that the more exotic a new drug is, the more difficult it tends to be to make in industrial quantities (and at the necessary purity - people are, after all, going to put it into their bodies and expect to get better, not dead).

All is not entirely lost in current directions, either - sufficient immune system strengthening will also help against bacterial invaders.

And as far as testing on children, get real - children are the very last patients to have any drug tested on them because (1) their body weights are lower than adults, and (2) their metabolisms tend to be faster. Those two factors make them much more sensitive to drugs than adults. And the only people who want new drugs tested on their children are those with children who will die otherwise, and that's not a particularly good test population. For some reason parents seem reluctant to offer the kiddies up for medical experiments. Can't imagine why...

[AdamSelene235]

Only collodial silver can save us now!!

[DumpsterDiver]

I think we have aproblem where the drug companies advertise where they say "if you have this (or may have this) go to your doctor and ask him for these pills." I think instead of a patient asking for something, except in extreme cases, the doctor should be the one to make that decision.

I agree. Sometimes, though, it's the doctor who prescribes the newest, (more heavily advertised) drug when there are older, safer drugs that work just as well and are cheaper. I find it pays to do your own research on what ails ya and be as informed as possible.

[waterstraat]

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