Open Medicine EU

Through misuse, non-compliance, and over-prescribing, as well as natural factors, we are running out of useful antibiotics. Four of the articles chosen as national finalists for the European Health Journalist prize 2011 are about the crisis. The titles of three of the articles give a flavour of the issue: “The end of Antibiotics” (Lithuania), “Losing the Superbug War” (Ireland) and “When the Drugs Don’t Work” (UK). The fourth (Sweden) gives a specific example of the more general problem.

(English translations of all the entries have just been published on the website – otherwise this blog would have been somewhat shorter.)

Gary Finnegan, the Irish finalist, highlights the problem but is pessimistic about the possibility of industry developing new antibiotics, for a particular reason. If an innovative and effective antibiotic were to be developed, he writes, it would be “quarantined” or kept for those cases that cannot be treated by existing medicines. (If it were released for general use it would lose its efficacy sooner.) However, quarantining would reduce the market and the likely revenue for the new product. In consequence, industry does not have an incentive to spend much research money on developing innovative antibiotics.

Ben Hirschler and Kate Kelland , the UK finalists, cover the same topic and report an industry view of where the problems lie. One industry source is cited as blaming the problem rather on an over-cautious approach by regulators – in terms of demanding more and much larger late-stage clinical trials. A more general factor cited is that antibiotics are short term drugs prescribed typically for a matter of weeks at most. As such they cannot produce the kind of revenue streams generated by medicines such as cholesterol lowering medicines that may be prescribed for life. Furthermore a new product could hardly compete in those areas where existing antibiotics are still effective, since existing antibiotics are becoming cheaper as their patents expire.

According to Thomas Lonngren, before his retirement as head of the European Medicines Agency this is an “an issue where commercial consideration doesn’t really match the public health need.”

In the Lithuanian entry, Monika Poskaityte describes some of the background to the growth of more resistant bacteria that has led to the current crisis. From Sweden Anna Larsson describes a case where the antibiotic problem is one of the factors forcing a rethink of the value of investigatory/medical procedures – for prostate cancer, in this instance. Effective antibiotics can reduce the risk of many medical procedures – without effective antibiotics the risk is correrspondingly greater. END

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