Opinion: What’s holding pharma back from the next antibiotic breakthrough?

In the five years since the alarm sounded about so-called superbugs, the world has continued to grapple with the staggering health and economic impacts of antibiotic resistance and mounting resistance to antibiotics of last resort.

In the U.S. alone, antibiotic resistance adds $20 billion to $35 billion in direct health care costs each year, along with 8 million extra days in the hospital. In the European Union, multidrug-resistant infections kill more than 30,000 people every year. While scientists work to uncover new ways to combat antibiotic-resistant microbes — which harbor a dizzying array of tools to evade antibiotics — the question of how to best develop and commercialize novel antibiotics while at the same time creating a return for investors remains just as puzzling as the most recalcitrant bacteria.

Any company considering investing in novel anti-infectives faces substantial commercial headwinds despite a clear and urgent need for them.

Cost pressure is one formidable obstacle. Any new antibiotic will face substantial pressure from competitors, as most antibiotic classes have now