title: Fighting antibiotic resistance: marrying new financial incentives to meeting public health goals.
abstract: The world faces a worsening public health crisis: A growing number of bacteria are resistant to available antibiotics. Yet there are few new antibiotics in the development pipeline to take the place of these increasingly ineffective drugs. We review a number of proposals intended to bolster drug development, including such financial incentives for pharmaceutical manufacturers as extending the effective patent life for new antibiotics. However, such strategies directly conflict with the clear need to reduce unnecessary antibiotic prescriptions and could actually increase prescription use. As an alternative, we recommend a two-prong, "integrated" strategy. This would increase reimbursement for the appropriate, evidence-based use of antibiotics that also met specific public health goals--such as reducing illness levels while limiting antibiotic resistance.
authors.affiliation: Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA.
authors.forename: Aaron S
authors.initials: AS
authors.lastname: Kesselheim
authors.forename: Kevin
authors.initials: K
authors.lastname: Outterson
mesh_terms: D000900:Anti-Bacterial Agents / Q000191:economics* / Q000627:therapeutic use; D003363:Cost Control / Q000592:standards; D055808:Drug Discovery / Q000191:economics*; D004345:Drug Industry / Q000191:economics; D024881:Drug Resistance, Bacterial; D006801:Humans; D017053:Infection Control / Q000331:legislation & jurisprudence / Q000592:standards; D009965:Orphan Drug Production / Q000191:economics; D011634:Public Health / Q000592:standards*; D012051:Reimbursement Mechanisms
chemical_list: D000900:Anti-Bacterial Agents