The main focus of last Sunday’s European Antibiotic Awareness Day (EAAD) was promoting the idea that appropriate, as-prescribed use of antibiotics can slow the spread of resistant bacteria in the continent.
But, while patient education clearly has a major role to play, drug industry economics may encourage marketing practices that fuel the superbug epidemic according to Danilo Lo Fo Wong, Senior Advisor on Antimicrobial Resistance of WHO Regional Office for Europe.
“Developing new antibiotics is a very complex process which implies substantial economic investments. As antibiotic resistance emerges faster than ever before, the window for earning back the investment and making profit has become very narrow.
“This could lead to intensive marketing strategies aimed at increasing antibiotic prescription and consumption," Dr Wong continued, citing promotional practices aimed at doctors and the payment of financial incentives to pharmacists as sales strategies that could “stimulate the unnecessary use and misuse of antibiotics by patients.”
He also suggested that direct advertising to patients may also “create an unnecessary demand for antibiotics.”
New business model
Instead, the WHO wants the pharmaceutical manufacturing industry to develop new antibiotics - through initiatives like BSAC, IMI, JPI AMR and ReAct - and by trying to uncouple return on investment from sales.
Wong told us that: “Delinking return on investment from sales… would likely involve some form of public funding that rewards the most promising research in various stages of development. This would mean that by the time of completion and distribution of a successfully developed new antibiotic, the investment has been paid off.
“Such a theoretical business model has not been fully conceptualized nor developed yet and will require much more discussion with key partners in private and public sectors. However, this can be the way forward if we want to limit the misuse of antibiotics and that novel antibiotics will be made globally accessible and affordable.
As another positive step, Wong suggested that “clear warnings on antibiotic packaging that they should be taken only as prescribed by a doctor…would help consumers understand that antibiotic work against bacteria, not viruses and that self-prescription of antibiotics contribute to developing resistance.”