Step up support for new antibiotics

By Pat Murphy

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The Centers for Disease Control and Prevention advises that there are 1.7 million hospital-acquired infections each year. These dangerous infections can complicate a patient's medical condition, extend the length of a hospital stay (or require re-admission) and are estimated to cost our health-care system $28 billion to $34 billion annually. According to the National Institute of Allergies and Infectious Diseases, between 5 percent and 10 percent of U.S. patients develop infections while in the hospital.

Most worrisome, antibiotic-resistant infections - an increasingly common form of hospital-acquired infections - lead to nearly 100,000 deaths each year.

The goal of every doctor, nurse and hospital staff member is to provide the best care possible to each patient. However, antibiotic-resistant infections are becoming increasingly challenging for anyone with the best of intentions to control.

Antibiotics are the historic defense against such infections. The problem is that over time, bacteria can evolve and adapt to their environment, becoming progressively more resistant to treatment. By transforming genetic structure, bacteria make the antibiotic used less effective, making it more difficult to remove infection from the body.

Americans of all ages are at risk. Children and infants are especially susceptible due to their underdeveloped immune systems. Older people are also exceedingly vulnerable.

There are some obvious steps that must be taken, and developing new antibiotics to counter these “super bugs” is one. Yet, the number of innovative antibiotics currently in the development pipeline is very low. This lack of development is, in itself, an urgent public health problem.

Various factors have contributed to the stall in research and development efforts. Foremost is “the economics of antibiotics”: Unlike other new effective medicines, which enjoy great demand and use, a newly effective antibiotic is appropriately kept in reserve. Moreover, unlike other medicines, it will encounter bacterial resistance over time. Yet clinical trials involving antibiotics are exceedingly complicated and come with high cost. Accordingly, the potential rate-of-return on antibiotic development is unduly low in comparison with that of other medicines. Thankfully, some in Congress have recognized the problem, and are moving to address it through proposed legislation - the Generating Antibiotic Incentives Now (or GAIN) Act. This federal legislation encourages the development of new antibiotics that could treat patients resistant to existing antibiotics. It provides incentives to increase both the security of and return on investment in new antibiotic treatments, and streamlines the regulatory process. It also allows for transparent clinical trial expectations designed to reinvigorate the current R&D pipeline.

The bill has bipartisan support and is also supported by numerous reputable organizations such as the Pew Charitable Trust, National Association of Children's Hospitals and the National Military Veteran's Alliance.

This is one of the big pieces toward addressing infections in hospitals that will further reduce our costs and improve the health of all. Without focused government action, the drug-resistance problem will continue to magnify and threaten the health and well-being of Americans.

Including the market incentives outlined in the GAIN Act into the Prescription Drug User Free Act is the best near-term opportunity for elected officials in Washington to make real progress in the battle against antibiotic resistance this year.

A bipartisan group in Congress, with the support of our Sen. Tom Harkin, worked hard to move this legislation through a key congressional committee.

It is a great example of Congress working across the political spectrum to solve real problems.

The time to act is now, let's get this done.

Pat Murphy, D-Dubuque, is a state legislator representing House District 28. Comments: pat.murphy@legis.state.ia.us