Addressing antibiotic resistance and the dearth of new drugs in development is a global concern, and the issue will require buy-in from stakeholders across the healthcare industry, experts say.
The National Institute for Health Care Management hosted a web event Wednesday that brought together representatives from the Centers for Disease Control and Prevention, the Food and Drug Administration, health policy experts, insurers and journalists to build a complete spectrum of ways the health system can take on the threat of superbugs.
It begins with better education, the experts said. Rick Young, a producer for PBS Frontline who spearheaded a series for the publication on drug resistance, said hospitals that step up and acknowledge the issue are doing a significant community service.
"It's a bit of a mind shift from seeing it as a marketing problem to seeing it as opposed to the medical emergency that it is—and that the public needs to see," Young said.
A recent report from the CDC identified 221 "nightmare" bacteria with what the agency described as "unusual" resistance. Those germs cannot be killed by any or most antibiotics, are uncommon in certain geographic regions or the U.S. as a whole, or can spread resistance to other bugs.
Another concern: Fee-for-service payment models for drugs are not driving the innovation needed to reduce the spread of these resistant pathogens, the experts said. But a value-based approach may be key.
The Margolis Center on Health Policy at Duke University, for example, has developed an alternative payment model designed to incentivize antibiotic development and stewardship among providers.
The model—called the Priority Antimicrobial Value and Entry (PAVE) Award—would offer rewards to drugmakers who enter the market with new antibiotics, while also pushing them to enter value-based purchasing contracts.
Monika Schneider, Ph.D., a research associate at Duke-Margolis, said at the web event that economic approaches to reducing the impact of superbugs require a mix of incentives to be effective. Antibiotic development in particular has a very low return on investment, she said, which can prevent crucial research.
"Clinical development can be very costly," Schneider said.
The World Health Organization has warned that the world is running out of effective antibiotics. Of the more than 50 medications currently in development, just eight are innovative therapies and not modifications of existing drugs, according to the global health group.
Enhanced research and development can also drive more appropriate use and prescribing habits, Schneider said, and antibiotic stewardship is viewed as a key solution to slowing the spread of resistant bugs.