securing new drugs for future generations: the pipeline ... - AMR Review

May 6, 2015 - this input along with the other ideas we are developing as we build to our final recommendations in summer 2016. FOREWORD: JIM O'NEILL, ...
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SECURING NEW DRUGS FOR FUTURE GENERATIONS: THE PIPELINE OF ANTIBIOTICS THE REVIEW ON ANTIMICROBIAL RESISTANCE CHAIRED BY JIM O’NEILL MAY 2015

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CONTENTS FOREWORD. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1

EXECUTIVE SUMMARY. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2

1. WHICH NEW DRUGS? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4 2.

IS THERE A PROBLEM WITH THE MARKET FOR ANTIBIOTICS



AND HOW SHOULD IT BE CORRECTED?. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11

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CREATING A MORE PREDICTABLE MARKET FOR ANTIBIOTICS



TO SUSTAIN COMMERCIAL INVESTMENT IN R&D. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 17

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THE AMR INNOVATION FUND - MORE MONEY FOR



EARLY-STAGE RESEARCH . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 23

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MID-STAGE INTERVENTIONS: OILING THE GEARS



OF ANTIBIOTIC DEVELOPMENT. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 26

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THE COSTS OF TAKING ACTION. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 28

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OUR NEXT STEPS: MOVING FROM IDEAS TO ACTION. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 29

APPENDIX A

COSTING A PACKAGE OF PULL INCENTIVES FOR NEW ANTIBIOTICS: WHAT AND HOW MANY ARE NEEDED? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 31

B. FURTHER INTERVENTIONS WE HAVE CONSIDERED BUT NOT CHOSEN TO RECOMMEND IN THIS PAPER. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 35 C.

MODELLING THE ANTIBIOTIC DEVELOPMENT PROCESS. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 38

ACKNOWLEDGEMENTS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 41

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FOREWORD: JIM O’NEILL, CHAIRMAN OF THE REVIEW Multiple factors drive the development and spread of antimicrobial resistance (AMR). It is a complex issue to which there is no single or simple solution, but for which the costs of inaction are huge. For these reasons, we decided at the start of our assignment that we would publish a series of papers on what we saw as the key challenges. It would allow us multiple opportunities to raise the broad topic, but in each case focus on a specific part of the challenge. We also decided to seek bold, simple but decisive solutions for us to influence the world and ensure that AMR does not have a chance of becoming a problem of the scale we identified. In our first paper, we showed that if we fail to act on AMR then an additional 10 million lives would be lost each year to drug-resistant strains of malaria, HIV, TB, and certain bacterial infections by 2050, at a cost to the world economy of 100 trillion USD. We have identified the wide variety of things we need to do to get to grips with t