Preventing another public health crisis

By TODD YOUNG
United States Senator

The COVID-19 pandemic demonstrated America’s vulnerability to catastrophic public health crises. And it highlighted the urgency of taking reasonable measures to prevent them in the future.

While it is not dominating current news headlines, the next public health crisis is already here: the emergence of bacteria resistant to antibiotic treatment.

Antimicrobials – including antibiotics – play a fundamental role in our health care system’s most common and most complex medical procedures, preventing infection, fighting disease, and saving lives along the way.

Antimicrobial resistance (AMR) occurs naturally when bacteria and other microbes evolve traits that make them more difficult to kill. Unfortunately, the overuse and misuse of life-saving antibiotics have dangerously accelerated this natural process, increasingly burdening our health system with infections that cannot be as effectively treated with antibiotics. In fact, research shows that roughly 30 percent of antibiotics used in hospitals are unnecessary or prescribed incorrectly.

As it stands, AMR is already far from an abstract public health threat. Today, the U.S. Centers for Disease Control and Prevention estimates that antibiotic resistance kills someone in the United States every 15 minutes, amounting to at least 35,000 lives lost annually. And unless our pharmaceutical innovators create new, more potent drugs, AMR is expected to be the leading cause of death worldwide by 2050.

Yet as these resistant infections rise and deaths are projected to increase, the global pipeline of antibiotics in development remains stagnant. This is because drug makers everywhere face unique disincentives when it comes to developing new antimicrobials: to slow AMR and keep these medications effective for as long as possible, many doctors rightly try to limit their use to only those cases in which they are truly necessary. But this limited use can result in low sale volumes, making it difficult for the companies developing and producing these innovative antibiotics to stay in business. As a result, there are far too few drugs in development to treat the most dangerous pathogens.

Over the last several decades, we have made significant advancements in areas like cancer, organ transplantation, and cystic fibrosis. But these advancements are undermined as patients lose their lives to untreatable resistant infections. Common procedures like hip and knee replacements and caesarian sections carry serious infection risks and are becoming more dangerous as our antibiotic options dwindle.

This is a growing public health threat, and Hoosiers should not have to worry that antibiotics are not doing their intended job. Our health system must preemptively combat antibiotic resistance and ensure we do not return to an era when even a simple medical procedure could be deadly.

The PASTEUR Act, which I introduced with Senator Michael Bennet (D-Colo.), incentivizes the development of new antibiotics, spurring urgently needed innovation. Currently, the drug reimbursement system in our country rewards volume, not value. The federal government pays for antimicrobials in a way that fails to drive innovation or appropriate use. The PASTEUR Act would introduce a new model for paying for novel antimicrobials – one that incentivizes the development of antimicrobials based upon the value they provide for public health, rather than the volume used.

The PASTEUR Act would help reinvigorate the antibiotics pipeline by providing sizable, subscription-based government contracts for access to innovative, high-priority antibiotics. Importantly, the federal government only pays once – the subscription payment is all-inclusive, and the PASTEUR Act only pays for success.

This approach addresses the core issue confronting the antibiotics market: the pressing need for effective, innovative drugs that don’t have high sales potential.

At the same time, the PASTEUR Act would focus on educating health care providers on how to avoid overuse or misuse of these life-saving medications in order to slow the emergence of antibiotic-resistant pathogens. It is a proactive initiative to meet an emerging crisis head on.

Every year we wait to address the crisis of AMR is another year patients and providers must struggle to access life-saving medicines. After our nation has endured a pandemic, this is the type of much-needed reform to our health system that all Americans will support. Our hard-earned experience from the last public health crisis can lead to a renewed motivation to prepare for the next one before it’s too late. Let’s pass the PASTEUR Act.

Todd Young, a Republican, serves Indiana in the United States Senate.