Extending the Cure: Policy Responses to the Challenges of Antibiotic Resistance

Evaluating incentives to reduce the demand for antibiotics and expand the supply of new ones

Antibiotic resistance stems from insufficient incentives for patients, physicians, hospitals, and drug companies to do the right thing.

Dates of Project: May 2005 to December 2011

Field of Work: Antibiotic resistance

Problem Synopsis: Modern medicine depends on antibiotics to control bacterial infections, but pathogens resistant to antibiotics have emerged and spread rapidly. The Institute of Medicine and many others have sounded urgent calls to address this growing threat, yet policy-makers have done little to respond.

Synopsis of the Work: Extending the Cure researchers evaluated antibiotics and resistance of them, and proposed incentives to make the best use of existing antibiotics and encourage the discovery of new ones. The researchers framed the problem as one of “the commons”: antibiotics are a shared resource like clean air and safe drinking water, and any use of these drugs diminishes their overall effectiveness.

Key Results: Extending the Cure researchers:

  • Published Extending the Cure: Policy Responses to the Growing Threat of Antibiotic Resistance, which concludes that patients, physicians, hospitals, and drug companies have insufficient incentives to conserve the effectiveness of existing antibiotics. What is good for each patient and entity conflicts with what is good for society.
  • Published 23 journal articles, and 13 policy briefs on antibiotic resistance and potential responses.
  • Launched the Drug Resistance Index, which tracks the resistance of microbes that cause common diseases, based on their resistance to individual drugs and the frequency with which clinicians prescribe them.
  • Developed the ResistanceMap, which shows changes in antibiotic use and the resistance of microbes to individual drugs across North America and Europe.

Related antibiotics create cross-resistance, so each drug company has little incentive to consider resistance if other firms are selling similar drugs.

#Superbugs. Public stewardship of antibiotics essential to wise use by docs, drug cos., and patients.

Discouraging inappropriate antibiotic use will require changing how patients and physicians are reimbursed for antibiotic prescriptions, and how physicians are paid for prescribing them.

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