“The market is broken,” says Zachary Zimmerman, co-founder and CEO of small-time antibiotic company Forge Therapeutics, which currently has two new antibiotics in development. “What we have to do is take the market out of the equation.”
This is what the Pasteur Act would have done. In its current form, it is offering $6 billion over several years to create a registration system to develop new antibiotics. The money came as a result of many things that happened in 2020, the bill required $ 11 billion – and it will not be spent on medicine. The proposed program in HHS will bring together teams of experts to assess whether newly introduced antibiotics meet unmet needs. He would then estimate the cost of the drug, from $750 million to $3 billion. The Treasury will pay the money over several years. In return, the government will receive doses of the drug to be distributed to insured patients, at no cost to them.
Compare the $6 billion cost to the $1 billion cost of producing a single drug, and it’s clear that the Pasteur Act doesn’t go far enough. It can support several new drugs before they need to be approved again. But experts who have been pushing for a program like this say it would not only prove a success, but would also demonstrate to the public and private markets that antibiotic production can be a viable investment.
“We hear loud and clear, especially from small pharmaceutical companies, that they see this funding approach as critical to the sustainability not only of their antibiotic candidates, but to the sustainability of their entire company,” he says. David Hyun, a physician and director of the Pew Charitable Trusts’ antibiotic resistance project.
There are several obstacles in the way. The first is that the returning Congress does not have much time. The second is that, in order to be successful, the Pasteur Act must be combined with a general law, at a time when many supporters are trying to achieve their goals. One car can be a full-service fund that also approves health care programs that are about to expire. Another would be the annual, bipartisan, often nonpartisan National Defense Authorization Act. With 66 cosponsors from both parties, Pasteur seems like a natural fit.
However, last week, a coalition of six students and 11 organizations – including the liberal groups Public Citizen and Doctors for America – asked the lawmakers in charge of military authorization to stop the action at the end of the year. In a letter to Sen. Jack Reed of Rhode Island and James Imhofe of Oklahoma — the Democratic chairman and Republican member of the Senate Armed Services Committee — the group called the Pasteur Act “a blank check for drug manufacturers.”
That criticism provides a glimpse into what could harm the Pasteur Act’s near-success: its cost. Many big companies are so disgusted by the high prices that the opportunity to give money to any drug maker is dangerous. However, although the small biotechs that are working on this may belong to pharma, it is not Big Pharma: most of them have few employees, they are working on their first job, and they are not earning anything, let alone repaying fraud. “We’re hearing: It’s just too much. We’re not ready to spend this much money,” said Mary Dwight, head of policy and advocacy at the Cystic Fibrosis Foundation, which has taken the Pasteur Act as a cause. “We want to address this issue, because it is clear that the fight against antimicrobial resistance is expensive.”
According to a study sponsored by the CDC, the US already spends $4.6 billion each year to respond to antibiotic-resistant infections. If the money could be withdrawn, it would save in one year more than the Pasteur Act would have cost in several.
“If Pasteur gets through, it’s not just going to help CF patients, it’s going to help everyone,” Brown says. “We’ve passed Covid, but if there are no antibiotics, then Covid seems to be the least of our worries. If a big problem comes out and there’s no one to work with, then we’re all going to be in trouble.”
