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#265311 - 11/15/13 02:34 PM Antibiotics and free market drug development
Ardy Offline
veteran

Registered: 12/22/05
Posts: 11703
Loc: San Jose, Ca USA
I recently watched a Frontline special on several emerging breeds of anti-biotic resistant bacteria.

In a nutshell, several severe medical threats are developing as bacteria evolve resistance to the most sophisticated currently available drugs.

The logical assumption would be that pharma companies would see this as an opportunity to develop new drugs.

FOr a variety of reasons, this does not appear to be the case. In fact, the last major pharma doing this work closed down it's research on this problem. So what gives?

Frontline intereviewed pharma management to try to understand their rationale.

Unsurprisingly, every pharma company answers to stockholders who demand a return on investment. This new breed of antibiotics is not a compelling profit center. In the firt case, development costs are very high.... about a billion dollars.

But is the ROI profile that is the barrier here. An anti-biotic is ideally a drug that is used only for a short period of time. Also, the nature of the drug is such that doctors should use it as little as possible in order to avoid anti biotic resistance to that new drug. And more sucessful the drug is, the less of it will be required.

Over all, the drug company is much better off working on drugs for chronic problems.... weight loss, diabetes, heart disease, erctile dysfunction, arthritis, etc. These are drugs that will have a long continuing demand.

So in the end, there is no freemarket motivation to work on this problem.... unless perhaps at some point the problem becomes large and pervasisve. But of course, by the time that happens, the drug development process will be starting a long process that will not be effective for years and years after the effort re-starts.


So, I am just proposing this as yet another example of how free markets do not always address problems in the optimal manner.
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#265368 - 11/17/13 09:15 AM Re: Antibiotics and free market drug development [Re: Ardy]
issodhos Offline
Pooh-Bah

Registered: 09/29/05
Posts: 12581
Originally Posted By: Ardy

So, I am just proposing this as yet another example of how free markets do not always address problems in the optimal manner.


What a curious response to an argument not made, Ardy. coffee
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"When all has been said that can be said, and all has been done that can be done, there will be poetry";-) -- Issodhos

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#265371 - 11/17/13 09:59 AM Re: Antibiotics and free market drug development [Re: issodhos]
chunkstyle Offline
journeyman

Registered: 10/01/07
Posts: 558
Forgetting for the moment that your hubris does not allow you the right to define what a free market is Iss, just finished reading an op/Ed price that I thought dovetailed nicely with what your discussing Ardy.
Free market perversion

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#265372 - 11/17/13 10:01 AM Re: Antibiotics and free market drug development [Re: Ardy]
chunkstyle Offline
journeyman

Registered: 10/01/07
Posts: 558
My apologies Iss. It might be helpfully if I asked you what your definition of a free market is and include an example, past or present, where your definition exists.

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#265373 - 11/17/13 10:08 AM Re: Antibiotics and free market drug development [Re: Ardy]
Ardy Offline
veteran

Registered: 12/22/05
Posts: 11703
Loc: San Jose, Ca USA
Here you go Iss


Quote:
Projecting future development, new antibacterial agents constitute 6 of 506 drugs disclosed in the developmental programs of the largest pharmaceutical and biotechnology companies. Despite the critical need for new antimicrobial agents, the development of these agents is declining. Solutions encouraging and facilitating the development of new antimicrobial agents are needed.
Journal of clinical infectious diseases

Quote:
"We're on the precipice of returning to the dark days before antibiotics enabled safer surgery, chemotherapy and the care of premature infants," said Dr. Helen Boucher, an infectious diseases expert at Tufts Medical Center in Boston and a member of IDSA's board, whose report was published online in Clinical Infectious Diseases.

"Simply put, the antibiotic pipeline is on life support and novel solutions are required to resuscitate it - now," IDSA President Dr. David Relman said in a statement.

Boucher said health officials are losing ground because companies are not developing drugs quickly enough to keep up with the superbugs' ability to develop resistance, adding: "We're all at risk."

link

Quote:
At a time when the need for antibiotics is high, pharmaceutical companies are abandoning antibiotics development in favor of larger, more predictable markets.
genetic engineering news

Quote:
Another reason is commercial. Antibiotics, in particular, have a poor return on investment because they are taken for a short period of time and cure their target disease. In contrast, drugs that treat chronic illness, such as high blood pressure, are taken daily for the rest of a patient’s life. “Companies have figured out that they make a lot more money selling the latter drugs than they do selling antibiotics,” Spellberg says, highlighting the lack of incentive for companies to develop antibiotics.

That’s why many companies have stopped developing antibiotics altogether. Only five major pharmaceutical companies
world hearlth org

Quote:
An important reason why drug companies do not focus efforts on antibiotics is that they are not financially viable to develop.

snip

The problem with antibiotics is that they do not fulfil this criteria. An antibiotic, as opposed to a drug for a long lasting affliction such as cancer, heart conditions or Multiple Sclerosis, is a comparatively “quick fix”. Antibiotics only need to be taken for short periods of time, and are therefore unlikely to earn the same financial rewards as other medicines. Added to that the risk of failed development and the dangers of trialling strong new antibiotics, and it is easy to see why drug companies generally choose to pursue less risky options.
science blog

Quote:
Costly endeavour
Efforts to develop new antibiotics have been hampered by scientific and regulatory hurdles, Goldman says, adding that clinical trials are extremely costly because of regulatory requirements and the large numbers of patients required. ‘At the same time, because some antibiotics will only be used on a very small number of patients, the costs of development often exceed the potential return on investment,’ he says. ‘In other words, antibiotic development is simply no longer a financially viable option for pharmaceutical companies, and just a handful of pharmaceutical companies remain in the field.’
chemistry world

Quote:
The current system for manufacturer return on investment for antibiotics, which are typically reimbursed at very low levels, is oriented towards volume sales. As a result, stewardship and educational programs geared toward limiting use of novel antibiotics create an ‘antibiotic development paradox.’ How can we incentivize investment in developing new effective antibiotics and also have successful programs that limit the use of these antibiotics in an effort to prevent or delay the development of resistance? Unless this fundamental conflict in the current business model is addressed, pharmaceutical firms are unlikely to expand development efforts.
brookings inst
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"Not everything that counts can be counted, and not everything that can be counted counts."

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#265374 - 11/17/13 10:48 AM Re: Antibiotics and free market drug development [Re: Ardy]
issodhos Offline
Pooh-Bah

Registered: 09/29/05
Posts: 12581
Originally Posted By: Ardy
Here you go Iss


Thanks for the factoids, Ardy, but they simply re-state the observation already posted by you concerning the Frontline story. However, the "argument" I am referring to is the one that is implied by your comment, " free markets do not always address problems in the optimal manner.", which would be, "Free markets always address problems in the optimal manner".

I am sure you are aware that the purpose of markets is to serve an economic purpose beneficial to those participating in it, and any societal good beyond that, that may flow from a market, is secondary to its primary function -- important and beneficial though such a societal good may be.

Yours,
Issodhos
_________________________
"When all has been said that can be said, and all has been done that can be done, there will be poetry";-) -- Issodhos

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#265377 - 11/17/13 10:59 AM Re: Antibiotics and free market drug development [Re: issodhos]
Ardy Offline
veteran

Registered: 12/22/05
Posts: 11703
Loc: San Jose, Ca USA
Originally Posted By: issodhos

I am sure you are aware that the purpose of markets is to serve an economic purpose beneficial to those participating in it, and any societal good beyond that, that may flow from a market, is secondary to its primary function -- important and beneficial though such a societal good may be.

Yours,
Issodhos


QUite right....
which implies that any social good produced by free markets is accidental. And that free markets might as well accidentally produce social bads in pursuit of profit.

It is the nature of free markets as you define them

which is why it is so wrong headed to depend upon free markets to produce a social good such as a health care system.
_________________________

"Not everything that counts can be counted, and not everything that can be counted counts."

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#265378 - 11/17/13 11:14 AM Re: Antibiotics and free market drug development [Re: chunkstyle]
issodhos Offline
Pooh-Bah

Registered: 09/29/05
Posts: 12581
Originally Posted By: chunkstyle
Forgetting for the moment that your hubris does not allow you the right to define what a free market is Iss, just finished reading an op/Ed price that I thought dovetailed nicely with what your discussing Ardy.
Free market perversion


I am puzzled as to why you believe that this article about the government-subsidized agricultural industry in the US has anything to do with free markets, Chunkstyle?
Yours,
Issodhos
_________________________
"When all has been said that can be said, and all has been done that can be done, there will be poetry";-) -- Issodhos

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#265385 - 11/17/13 11:39 AM Re: Antibiotics and free market drug development [Re: issodhos]
logtroll Offline
old hand

Registered: 04/25/10
Posts: 6351
Loc: New Mexico (not old Mexico)
You guys ain't lookin' at the big pitcher. This hyar is the free markit at work on global popalation control, somethin' that the gummit cain't seem to git a handle on reglatoraly.

The free markit is worrid about the triple-bottom-line - kill off a bunch a hoomans an' the remaining peeples and planet prospers, an' the drug lords made there profit. Free markit = rilly dandy! ThumbsUp
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#265391 - 11/17/13 12:07 PM Re: Antibiotics and free market drug development [Re: Ardy]
california rick Offline
Member
Carpal Tunnel

Registered: 05/09/05
Posts: 36236
Loc: Portland, Oregon

I saw the very same Frontline Ardy. There's no money return in spending R & D dollars on super-BACs. Investors, Ardy, investors.
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