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A new business model is needed to drive antibiotic development


The current business model for antibiotics is plagued by market failures and perverse incentives that both work against conservation efforts and provide insufficient rewards to drive the development of much-needed new treatments for resistant infection according to Kevin Outterson, from Boston University School of Law, Boston, US and Chatham House, UK, and colleagues in an Essay published in PLOS Medicine.

In their Essay the authors outline how a business model that delinks rewards from sales volume of an antibiotic could work. In addition they describe critical issues that need to be overcome to make this business model a reality so that new antibiotics could be developed and conserved to avoid the development of resistant bacteria.

The authors conclude, "[t]he UK's [Antimicrobial Resistance] Review, led by Lord Jim O'Neill, proposed that "a successful intervention must partially or fully 'de-link' profit from sales" ... With this growing focus on antibiotic delinkage, we see the need for a global conversation that applies delinkage principles to address access, conservation, and innovation of antibiotics in concert and not in isolation."




No specific funding supported the work.

Competing Interests:

AS's work on antibiotic resistance is supported both by a Swedish Sida grant for ReAct -- Action on Antibiotic Resistance and as a recipient of the Robert Wood Johnson Investigator Award in Health Policy Research. CC is Chair of the Governing Board of the Medicines Patent Pool. The remaining authors have declared that no competing interests exist.


Outterson K, Gopinathan U, Clift C, So AD, Morel CM, Røttingen J-A (2016) Delinking Investment in Antibiotic Research and Development from Sales Revenues: The Challenges of Transforming a Promising Idea into Reality. PLoS Med 13(6): e1002043. doi:10.1371/journal.pmed.1002043

Author Affiliations:

Boston University School of Law, Boston, Massachusetts, United States of America Chatham House Centre for Global Health Security, London, United Kingdom DRIVE-AB, Innovative Medicines Initiative, Geneva, Switzerland Oslo University Hospital, Oslo, Norway Norwegian Institute of Public Health, Oslo, Norway Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, United States of America ReAct - Action on Antibiotic Resistance, Uppsala, Sweden London School of Economics, London, United Kingdom University of Oslo, Oslo, Norway Harvard School of Public Health, Boston, Massachusetts, United States of America



Kevin Outterson
Boston University School of Law
Professor of Law & N. Neal Pike Scholar in Health and Disability Law
765 Commonwealth Avenue
Boston, MA 02215

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