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Can we make the an­tibi­ot­ic mar­ket great again?

The stan­dard for-prof­it mod­el in drug de­vel­op­ment is straight­for­ward. Spend mil­lions, even bil­lions, to de­vel­op a med­i­cine from scratch. The re­turn on in­vest­ment (and ide­al­ly a tidy prof­it) comes via vol­ume and/or price, de­pend­ing on the dis­ease. But the string of big phar­ma ex­its and slew of biotech bank­rupt­cies in­di­cate that the mod­el is sore­ly flawed when it comes to an­tibi­otics.

The in­dus­try play­ers con­tribut­ing to the ar­se­nal of an­timi­cro­bials are fast dwin­dling, and the pipeline for new an­tibi­otics is em­bar­rass­ing­ly sparse, the WHO has warned. Drug­mak­ers are en­ticed by green­er pas­tures, com­pared to the long, ar­du­ous and ex­pen­sive path to an­tibi­ot­ic ap­proval that of­fers lit­tle fi­nan­cial gain as treat­ments are typ­i­cal­ly priced cheap­ly, and of­ten lose po­ten­cy over time as mi­crobes grow re­sis­tant to them.

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