Antibiotics are too cheap

It's a common trope to bemoan the lack of resources that pharma companies put into antibiotic development. But why should they, when so much more money can be made in other fields? The newest example can be found in the excitement over Xofigo, which increases median survival in metastatic prostate cancer from 11 to 15 months. A positive step, but calling it a "big deal", as the Cleveland Clinic's Robert Dreicer did, speaks more to how awful most cancer treatments are.

The cost? $69,000, fully reimburseable by insurance. And the side effects? 47% serious adverse events vs 60% for the standard treatments. This may be the best thing out there, but it is still a terrible drug by any objective standard.

Compare this to the performance of anti-MRSA drugs. Without antibiotics (or inappropriate ones) the 30-day mortality for bacteremia is > 80%; with appropriate antibiotic treatment it is about 25%. Serious adverse event rates are typically a few percent. Drug costs are some $120 for vancomycin, and 10 times that for daptomycin, which is considered to be scandalously expensive.

It would be nice if pharma companies were willing to spend hundreds of millions of dollars to develop a drug that they can sell one time for a hundred dollars; but we don't live in that world. The fault is ours: we fear cancer and are willing to spend almost anything to hang on, sick and miserable, for a few additional months. We don't fear bacterial infections nearly enough, it seems.

Antibiotics are too cheap. As Laurie Piddock put it: "The price of antibiotics needs to relate to their value to society and should not relate to the price of previous products." Until we begin to value a life lost to infection as highly as a life lost to cancer we can expect to see little investment in new ant-infectives.

 

Posted with Blogsy