Drug companies aren’t making new antibiotics. Is there an economic cure?

JUDY WOODRUFF: Now to our series on the hunt
for new antibiotics, as superbugs and bacteria are building more resistance to the current
line of drugs. It is a joint project from our correspondents
Paul Solman and Miles O’Brien. Last night, Paul looked at why the market
for developing new drugs is simply no longer working. But, as one expert warned, antibiotics are
a class of drugs that could be lost for treatment if there’s no new investment. As part of his series Making Sense, Paul looks
at some new options for solving that problem. PAUL SOLMAN: Northeastern University biologist
Slava Epstein has traveled the world on the hunt for hitherto undiscovered microbes. Some trips are shorter than others. MILES O’BRIEN: We are five minutes from your
lab, right in the heart of Boston, and this soil is as good as any? DR. SLAVA EPSTEIN, Northeastern University: This
soil is as good as any. PAUL SOLMAN: As Professor Epstein told my
“NewsHour” counterpart on the science beat, Miles O’Brien, just about any handful of soil
contains tens of thousands of different microbial species, 99 percent of which remain utterly
unexamined, in part because they refuse to grow in petri dishes. Epstein’s breakthrough was figuring out how
to cultivate them, inventing a gizmo that isolates individual bacteria, then grows them
back into teeming colonies. So, you can kind of see through them there. AMY SPOERING, Research Director, NovoBiotic:
That’s right. So, in each one of those individual holes,
in theory, there is a single cell. And by capturing single cells and putting
them back out into the environment that they came from, you can cultivate microorganisms
no one has ever cultured before. PAUL SOLMAN: Amy Spoering is research director
at NovoBiotic, the company Slava Epstein co-founded to study newfound bacteria, now up to 60,000
strains, and counting, as potential sources of new antibiotics. And how does that work? SLAVA EPSTEIN: Antibiotics are produced by
microorganisms to kill their neighbors, so the enemies, the competitors. This is an exercise that the microorganisms
have been going through for the past four billion years. PAUL SOLMAN: And that humans have exploited
for the past century or so, with chemicals from microorganisms like penicillium, the
mold that makes penicillin. The trick is finding chemicals that kill infections
in people without killing the people too. So, I don’t mind interviewing movers and shakers,
but it’s actually making me slightly dizzy, so I’m just going to look at you. AMY SPOERING: Just look at me. That’s fine. PAUL SOLMAN: So, what is this? AMY SPOERING: So, what this is, is, this is
where we grow all of the novel microorganisms that we cultivate. They need a large amount of air in order to
grow well, in order to produce the antibiotics. PAUL SOLMAN: So you’re aerating them? AMY SPOERING: That’s right. That’s why they’re shaking. PAUL SOLMAN: So far, they have identified
33 novel compounds here, one of which may be a breakthrough: a new antibiotic that kills
bacteria in two completely different ways, making resistance much less likely. AMY SPOERING: So, this is making our lead
compound, teixobactin. PAUL SOLMAN: And the cost, if all goes well,
of eventually getting it to market? AMY SPOERING: That’s big money. PAUL SOLMAN: Big money that investors would
be tripping over one another to provide, right, to get in on the ground floor of the next
Z-Pak. AMY SPOERING: The payout will be huge, if
we are successful. PAUL SOLMAN: But it’s a long lug, says Spoering,
between bug and drug. AMY SPOERING: This is 30 liters of it growing
to produce the compound that we need to do the next set of pre-clinical tests. PAUL SOLMAN: And then, after you have done
those animal trials, the toxicology trials… AMY SPOERING: Yes. PAUL SOLMAN: … then, and only then, do you
do trials on humans? AMY SPOERING: First, an initial set of studies
that is just for safety, and then you move on to the efficacy studies, which is phase
two, and then much larger efficacy studies, which are phase three, clinical trials. DALLAS HUGHES, President, NovoBiotic: Drug
discovery is a very long process. PAUL SOLMAN: Dallas Hughes is NovoBiotic’s
president. DALLAS HUGHES: We are talking with venture
capitalists now, but venture capitalists aren’t going to become interested until we discover
a compound like teixobactin and move it forward a bit farther than it is now. And we’re hoping to raise some financing soon. PAUL SOLMAN: But, for now, they’re relying
on government and foundation grants. SLAVA EPSTEIN: Promising something that may
or may not happen 10 years from now doesn’t make people as excited as if you were promising
the results like here. PAUL SOLMAN: But, hey, every drug costs a
fortune to bring to market. That can’t be the reason antibiotic firms
like this one have such a tough time raising private capital. So, what’s the story? As we explained in a prior report, there just
isn’t enough profit soon enough. You buy a week’s worth of an antibiotic, not
three months, say, of Harvoni for hepatitis C. NARRATOR: That’s one pill, once a day, for
12 weeks. PAUL SOLMAN: And it costs about $30,000 a
month. Moreover, when a company comes up with a new
superbug slayer, the medical community wants to keep it off the market as long as possible
to delay toxic microorganisms developing resistance to it. Meanwhile, the patent runs out. Small wonder that even big pharma has said
no mas. DR. JOHN REX, Former Pharmaceutical Industry Executive:
Most of the companies that were really doing the large-scale development work backed away
from the area. PAUL SOLMAN: Like AstraZeneca, where infectious
disease Dr. John Rex used to head antibiotic development. What did he learn from his tenure? DR. JOHN REX: It’s a good way to destroy $50 million
to $100 million worth of net present value after 30 years of really hard work. PAUL SOLMAN: But ever-hopeful startups like
this one, Tetraphase, outside Boston, have popped up. And a new public-private partnership called
CARB-X has stepped in to help fund their trek from test tube to clinical trials. KEVIN OUTTERSON, Boston University: We have,
at CARB-X, $455 million over the next five years, but what we need globally across all
countries is about $2 billion per year for antibiotic R&D, supported by public and charitable
funds. PAUL SOLMAN: So, says executive director Kevin
Outterson. KEVIN OUTTERSON: This is an infrastructure
investment that has to be made in order to keep this drug class alive. I think antibiotics is the most valuable drug
class in human history. It’s done more to save lives than any other
drug class. It’s incredibly powerful. But it’s the only one that, if you don’t keep
investing, you lose it. Every other invention of modern medical science
is still going to work in 100 years. Antibiotics, we know they won’t. PAUL SOLMAN: Because bugs resistant to the
antibiotic will evolve. But what cure can economics possibly come
up with, when the market itself fails? KEVIN OUTTERSON: The model that people are
coalescing around is some sort of a significant prize, a significant billion-dollar payment,
that rewards them for the innovation, and then we can still use that antibiotic sparingly
for the next 10 or 20 years. PAUL SOLMAN: Rich prizes, they have motivated
everything from discovering a way to determine longitude at sea, to Charles Lindbergh’s transatlantic
solo flight in 1927, to private space flight today. DR. PETER DIAMANDIS, XPRIZE: We have got $50 million
of prizes on the table right now, and $200 million of prizes in development at different
stages in the pipeline. DANIEL BERMAN, Longitude Prize: Prizes can
be the answer when you’re trying to motivate people beyond the normal suspects. PAUL SOLMAN: Daniel Berman is in charge of
today’s so-called longitude prize, 10 million British pounds for a quickie test to see if
you need antibiotics at all. NARRATOR: One of the main reasons why drug
resistant infections occur is that antibiotics are used inappropriately, such as people taking
the wrong ones or not needing them in the first place. DANIEL BERMAN: We need a rapid diagnostic
test because we need to make sure that we don’t burn through the few antibiotics that
are left. And when new antibiotics come on, we have
to make sure that we dramatically use them in a more rational way. PAUL SOLMAN: Without such a test, doctors
are under constant pressure to prescribe. DR. LINDSEY BADEN, Infectious Disease Specialist:
Often, acute infections are viral, and without the ability to specifically diagnose you at
the point that you’re in the office, it’s very hard to know that an antibiotic won’t
help. PAUL SOLMAN: Boston infectious disease expert
Lindsey Baden. But to just distinguish between a virus and
a bacterium, that would be a big deal. DR. LINDSEY BADEN: A virus and bacterium would
be very important. PAUL SOLMAN: And even more so in developing
nations. DANIEL BERMAN: For example, in India, you
can still purchase antibiotics without a prescription in a lot of places. And people are dying because, for some pathologies,
there are simply no antibiotics that work anymore. PAUL SOLMAN: But look, says Slava Epstein: SLAVA EPSTEIN: Can you use antibiotics smarter? Absolutely. But that will not prevent antimicrobial resistance. It will delay it. PAUL SOLMAN: That’s why, he says, we must
ramp up the efforts and investments in new ones. This is economics correspondent Paul Solman,
reporting for the “PBS NewsHour.” JUDY WOODRUFF: And I’m still dizzy from the
shaking. Join us next week as Paul and Miles continue
their series.

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