title: Funding Antibiotic Innovation With Vouchers: Recommendations On How To Strengthen A Flawed Incentive Policy.
abstract: A serious need to spur antibiotic innovation has arisen because of the lack of antibiotics to combat certain conditions and the overuse of other antibiotics leading to greater antibiotic resistance. In response to this need, proposals have been made to Congress to fund antibiotic research through a voucher program for new antibiotics, which would delay generic entry for any drug, even potential blockbuster lifesaving generics. We find this proposal to be inefficient, in part because of the mismatch between the private value of the voucher and the public value of the antibiotic innovation. However, vouchers have the political advantage in the United States of being able to raise sufficient amounts of money without annual appropriations from Congress. We propose that if antibiotic vouchers are to be considered, the design should include dollar and time caps to limit their volatility, sufficient advance notice to protect generic manufacturers, and market-based linkages between the value of the voucher and the value of the antibiotic innovation. We also explore a second option: The federal government could auction vouchers to the highest bidders and use the money to create an antibiotics innovation fund.
authors.affiliation: Kevin Outterson (mko@bu.edu) is a professor in the School of Law at Boston University, in Massachusetts.
authors.forename: Kevin
authors.initials: K
authors.lastname: Outterson
authors.affiliation: Anthony McDonnell is a lead research economist for the Review on Antimicrobial Resistance, in London, United Kingdom.
authors.forename: Anthony
authors.initials: A
authors.lastname: McDonnell
mesh_terms: D000900:Anti-Bacterial Agents / Q000600:supply & distribution / Q000627:therapeutic use; D055808:Drug Discovery / Q000191:economics* / Q000379:methods; D004345:Drug Industry / Q000191:economics*; D004352:Drug Resistance, Microbial; D016568:Drugs, Generic / Q000191:economics; D006078:Government Programs / Q000191:economics; D006291:Health Policy; D006801:Humans; D062069:Inventions / Q000191:economics*; D009042:Motivation; D014481:United States
chemical_list: D000900:Anti-Bacterial Agents; D016568:Drugs, Generic
keywords: Biotechnology; Financing Health Care; Legal/Regulatory Issues; Pharmaceuticals