Commentary: Fix the Market Challenges Behind Microbiome-Sparing Antibiotics

AMR Action Fund CEO Henry Skinner, PhD, authored a commentary in CIDRAP examining the growing interest in microbiome-sparing antibiotics and the economic barriers that threaten to impede their development. In the piece, Skinner explains that while advances in microbiome science are highlighting the need and creating opportunities for more targeted antimicrobial approaches, innovation will remain limited unless policymakers address the longstanding market failures that have undermined investment in antibiotic R&D.

For a problem as significant and costly as antimicrobial resistance, the type of innovation we need will emerge only if policymakers create the conditions for it to flourish. Until the downstream dysfunction of the antibiotic market is addressed, many promising innovations will be unable to advance through development and reach the patients who need them.

If policymakers want antibiotics that are more precise and less disruptive to beneficial bacteria, they must create the market conditions that make them investable. That is the aim of pull incentives such as the PASTEUR Act, which would delink an antibiotic's revenue from its sales volume, giving investors greater confidence that successful products will be rewarded and encouraging the kind of scientific risk-taking that true innovation requires.

A well-designed pull incentive can also offer an elegant mechanism for encouraging microbiome-focused innovation. If the PASTEUR Act were enacted, lawmakers could design eligibility criteria that place greater emphasis on microbiome-sparing therapies and other innovative approaches that leverage beneficial bacteria to prevent or treat infection.

Read the full CIDRAP commentary here.