Depletion of antibiotics: Pharmaceutical companies turn their research programs in turn

Currently, we have more than 100 types of antibiotics. But there are bacteria resistant to all existing drugs.

Novartis (Switzerland), one of the largest pharmaceutical companies on the planet, announced last week to withdraw from the study of new antibiotics and antiviral drugs. More notably, this move is in a general trend: Previously four other major pharmaceutical companies, AstraZeneca (England), Sanofi (France), Eli Lilly (USA) and Allergan (Ireland) have also stopped studying. antibiotics because this array is not profitable.

According to the warning of scientists in Nature Biotechnology, there are currently only 4 major pharmaceutical companies maintaining antibiotic research programs: Merck (Germany), Roche (Switzerland), GlaxoSmithKline (UK) and Pfizer ( America). Since the beginning of the century until now, 12 new antibiotics have been approved to reach patients, but most are not strong antibiotics.

The withdrawal of major pharmaceutical companies is against the appeal of the World Health Organization (WHO), in order to find new drugs to help people win the antibiotic resistance crisis.

Right now, there are an average of nearly 2,000 people dying every day in the world because of drug-resistant viruses. Without preventive measures, the number could increase 15 times by 2050, according to an authorized report by the British government.

Every day in the world, an average of nearly 2,000 people die from drug-resistant viruses.

For profit

Declared to close the antibiotic and antiviral program offered by Novartis before sacking 140 research staff at the Emeryville, California headquarters.

"While science behind these areas is very attractive, we have decided to prioritize our resources in other areas, where we believe we are in a better position to develop the types. Modern drug for the benefit of patients, " Novartis said.

The company will sell copyright or research results in its 2-year period, since 2016 when it decided to participate in the search for new antibiotics, but has now given up.

It is not difficult to predict the main reason behind Novartis' withdrawal, or before that other well-known pharmaceutical companies such as AstraZeneca, Sanofi, Eli Lilly and Allergan. It is the study of new antibiotics that is becoming more and more difficult and even if it succeeds, new drugs are not profitable.

On average, pharmaceutical companies need to spend about $ 1.2 billion to successfully develop a new antibiotic. If it fails, the company will suffer even greater losses, up to $ 2.5 billion. On the market side, they can only sell antibiotics at a price of US $ 20-200 for a short-term treatment of 1-2 weeks.

Calculations show that profits cannot compensate for development investment costs. Especially with new antibiotics, they are recommended to store and only use when the old antibiotics do not work. This predicts new antibiotic sales will be even more pathetic, strangling companies' profits.

For this reason, pharmaceutical companies including Novartis want to target more lucrative markets including cancer drugs, chronic diseases such as diabetes, or even erectile dysfunction drugs. Positive selling is more profitable than antibiotics

For example, an average cancer treatment for a patient requires up to $ 20,000 in medicine, 100-1,000 times more than antibiotics. And the story with chronic diseases like diabetes is that patients have to buy drugs for life, not just 1-2 weeks as treatment for infections.

Profit from antibiotics does not offset expensive research costs.

Easy to do, hard to remove

In the past, new antibiotics were found by simply cultivating microorganisms such as fungi or bacteria isolated from soil or plants. Scientists have used this method to find penicillin, cephalosporin, aminoglycoside, rifamycin, tetracycline . until the glycopeptide antibiotics.

The principle of natural selection has helped some microorganisms produce chemicals, capable of killing other microorganisms including bacteria competing for living space and occupying food around them.

Just a simple experimental model - a little soil, a culture vessel, a extraction tube, a test plate and an incubator - are scientists who can find new antibiotics.

After that, they just need to refine chemical molecules a bit, transfer them to pharmaceutical companies that produce commercially and market them.

The problem starts here. When the experiments were too easy, and the bacteria in the soil were "with their hands", every scientist and pharmaceutical company rushed to research and found dozens to hundreds of different antibiotics.

Even, people used to have excess antibiotics to use."Antibiotics need antibiotics? Choose a new drug" , that is Abbott's advertisement in 1954, when they found erythrocin.

The antibiotic market has also been developing continuously from 1940-1970, especially from the demand arising from World War II. It motivates pharmaceutical companies to constantly launch new products.

When they find new antibiotic compounds, they combine many compounds to create a single pill to kill many different bacteria.

Antibiotic market has been developing continuously from 1940-1970.

Beyond the boundaries of the free market, companies also develop antibiotic businesses by encouraging doctors to prescribe antibiotics more often. Drug salespeople and pharmaceutical advertisers urge doctors with the " presumptive " message later. Patients are given antibiotics before the test results are available.

Not to mention, it is also the trend of antibiotic outbreak that has pushed consumers to use it to treat flu. Antibiotics are so widespread that new antibiotics reach poor quality.

For example, Chloramphenicol, the antibiotic used to treat flu, has no effect but can cause a deadly risk of aplastic anemia. Basically, it kills the bone marrow where your blood is produced.

The crisis with poor quality drugs has tightened antibiotic testing. It makes new drugs need more investment of time and money if they want to appear on the market.

Plus, it's easy to find all natural antibiotic compounds. It is like an apple tree that all apples near the ground have been picked. We will have to go higher to pick up the remaining apples.

And everyone knows it is more difficult. Scientists cannot reach the hands of new types of fungi or microorganisms for testing. They had to dive into coral reefs, search the deep bottom of the ocean and in the end of caves.

All this hard effort is only to find promising chemical molecules. But on average, pharmaceutical companies take 13-15 years to produce a new antibiotic, consuming huge amounts of money on chance.

When easy, companies test each other for antibiotics.When they are difficult, they compete.

Deplete antibiotics

Even during the Nobel Prize ceremony in 1945, the father of antibiotics Alexander Fleming gave a warning about a bright future: "Those who abuse penicillin today, they are responsible for death of patients infected with penicillin-resistant bacteria later ".

Fleming's prediction quickly became a reality. In 1943, penicillin was released and in 1945, penicillin-resistant bacteria appeared. People go looking for new antibiotics. In 1972, vancomycin was prepared and vancomycin-resistant in 1988.

Imipenem was born in 1985 and in 1998, imipenem resistance appeared. One of the newest antibiotics of humanity, daptomycin was born in 2003, only one year later appeared resistant bacteria.

This is like a sheep jumping game. The drug is born, bacteria are resistant to it and then we look for a new drug. But it seems that humans are short of breath when a new strain of bacteria is born every 20 minutes, pharmaceutical companies need a decade to study an antibiotic.

Currently, we have more than 100 antibiotics, but more and more bacteria are resistant to all existing antibiotics.

Last year, the World Health Organization announced a list of 12 antibiotic-resistant viruses, with the desire to push scientists, governments and pharmaceutical companies around the globe to act together. How to make all of them join hands in developing new antibiotics.

However, with a series of pharmaceutical companies such as AstraZeneca, Sanofi, Eli Lilly, Allergan and now Novartis stopping antibiotic research projects, WHO's goal is at stake.

It is estimated that to solve the antibiotic resistance problem, every 15 years we need to have 15 new antibiotics. In it, at least 4 types can be used to treat the most dangerous bacteria.

This responsibility is being placed on the shoulders of the remaining four big men, Merck, Roche, GlaxoSmithKline and Pfizer. On the one hand, governments and organizations still persuade large companies to maintain their antibiotic research programs with subsidies, on the other hand, they also encourage small and medium-sized companies, even starters. ups participate in this work.

The European Union (EU) has a program called Innovative Medicines Initiative (IMI) , which promotes the development of new drugs. In it, they committed to invest nearly $ 1 billion to use as a source of funding for basic research on antibiotics.

In the United States, the National Institutes of Health (NIH) also invests more than $ 5 billion (17% of total funding) in infectious diseases research. This figure is roughly comparable to the amount invested in anti-cancer research, about 5.4 billion USD (18%).

The United Nations and G20 national groups also want to develop a global alliance to coordinate activities against antibiotic-resistant bacteria.

It is expected that the action programs in the report could cost up to 40 billion USD. But let's look at the $ 100 trillion in damage caused by antibiotic resistance, predicted by 2050 and the number of 10 million people who die each year, which is a worthwhile investment.

In 2018, the US Congress increased funding for the Centers for Disease Control and Prevention (CDC) to $ 168 million to address antibiotic resistance.

The US Department of Health and Human Services also has two sources of capital to encourage the development of new antibiotics called CARB-X and BARDA. The US Food and Drug Administration said the agency is partnering with small and medium-sized companies to study bacteria and develop new antibiotics.

Even so, the results of these efforts are very limited. FDA said that in 2017 they approved two new drugs, but they were all old antibiotics. One of them does not have a strong enough effect to fight the virus. Only 1 more antibiotic has undergone all stages of clinical trial pending licensing.

The remaining, according to the PEW Research Center report, currently has 16 drugs in clinical trials stage 1, 14 in stage 2 and 15 in stage 3. Health experts say this amount not enough to solve the current antibiotic resistance problem.

Our antibiotic production pipeline is so depleted that some legislators have to call for a cut in standard tests to speed up the production of antibiotics.

In exchange for this option is a bad prospect, we will have to return to the 1960s with less safe and effective drugs, like Chloramphenicol.