Neil Gandhi is a resident in emergency medicine at the University of California Los Angeles, in Los Angeles, California. He was a graduate student at the Stanford University School of Medicine, in Stanford, California, when this work was performed.
Kevin A. Schulman (
Health Aff (Millwood). 2021 Dec;40(12):1926-1934. doi: 10.1377/hlthaff.2021.00062.
Despite growing antibiotic resistance, the clinical drug development pipeline for antibiotics has been sparse largely because of an unsustainable business model. We illustrate three models to accelerate antibiotic development, using Medicare new technology add-on payments as a market support mechanism. The first two models subsidize drug development for Medicare beneficiaries, and the third model applies a payment for every patient with a resistant infection to essentially create a funding pool. We found that the reimbursement required to sustain research and development would range from $637 to $121,365, depending on the payment model and the incidence of the resistant infection in question. With a $300 million public research subsidy, the payment for an antibiotic would drop to between $273 and $10,396 per course. Our market support model could increase the likelihood of attracting private investment for antibiotic development.
尽管抗生素耐药性日益增强，但临床抗生素药物研发管道仍然稀缺，主要原因是商业模式不可持续。我们举例说明了三种模型，以使用医疗保险新技术附加支付作为市场支持机制来加速抗生素的开发。前两种模型为医疗保险受益人补贴药物研发，第三种模型则对每位耐药性感染患者进行支付，实质上是创建一个资金池。我们发现，维持研发所需的报销金额将根据支付模式和耐药感染的发生率而有所不同，范围从 637 美元到 121365 美元不等。如果有 3 亿美元的公共研究补贴，那么每次疗程的抗生素费用将降至 273 美元至 10396 美元之间。我们的市场支持模型可以提高吸引私人投资进行抗生素开发的可能性。
