Epoch 48: Why Novel Antibiotic Development Does Not Attract Investment

Mechanisms of Action, Clinical and Commercial Landscape, Paths Forward

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Hello Avatar! Welcome back for another week of biotech analysis. This week we are going to explore the underinvested area of antibiotics.  The lack of innovation around antibiotic therapeutics (aka anti-infectives) is an emerging theme which should be of major concern to you - it certainly is a MAJOR concern to hospitals around the globe.  Despite the unmet need there unfortunately remains very little investment in this space compared to other therapeutic areas such as oncology, I&I and rare disease.  We will begin today’s discussion with a survey of the antibiotic landscape.  We will then explore the drivers preventing higher investment into antibiotic drug development and finally conclude with potential solutions to this issue.

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INTRODUCTION

Todays discussion will draw from a BIO report titled: The State of Innovation in Antibacterial Therapeutics by David Thomas, CFA and Chad Wessel from Feb 2022 - the report is a bit dated but still very much relevant.

Antibiotics are arguably the greatest drug class discovered from the 20th century. Their availability completely transformed human health and lifespan. In fact the majority of antibiotics discovered during that time period are still in use today!

Despite the effectiveness of this drug class, antibiotic resistance has become a rising concern amongst physicians, particularly in the hospital setting. Presently, over 1.2M global deaths yearly are linked to antibiotic-resistant infections, a number projected to reach 10M annually by 2050. In the U.S., over 2.8M antibiotic-resistant infections occur yearly, leading to more than 35,000 deaths.

In the upcoming decades, the diminishing effectiveness of previous bacterial defenses could turn millions of presently treatable infections into life-threatening conditions.  This includes a number infections already with high prevalence:

• Clostridium difficile: ~500k/year

• Skin infections: 14M/yr

• Streptococcus pneumoniae: 900k/year

• Sexually transmitted diseases

  • Gonorrhea: 700k/year

  • Syphilis: 200k/year

  • Chlamydia 1.7M

• Mycobacterium tuberculosis infection (TB): 10M/year

Today, we will explore recent investment trends in antibacterial innovation and examine the current clinical pipeline aiming to address gaps in our antibiotic toolbox. The discussion will highlight a concerning decline in funding for antibiotics, despite the increasing healthcare burden. As already noted, this decline coincides with a rise in infections and reports of antibiotic resistance.