When a risk starts to become unacceptable, and mitigations are not obvious, you need to look at other activities for ideas.
Antibiotics only became widely and cheaply available after the Second World War in the late 1940s, but now resistance to antibiotics is becoming a problem. Currently, around 700,000 people a year die because microbes have become resistant to the antibiotics they have been prescribed. It is estimated that this will rise to around 10 million people a year by 2050 with an economic impact similar to the last financial crisis.
One of the issues in addressing this risk is that pharmaceutical companies have pulled out of research into antibiotics because they can’t make money out of them. Indeed, one biotech company went bankrupt in April, not through poor management but because of how the market functions.
It takes around a decade to develop a new drug and about $1bn. But doctors tend to use a new antibiotic very slowly in the first few years of its life in order to avoid the potential for resistance to develop. So sales are low and slow, and that can be enough for companies to go bust and for investors to bail out of the market. And so the flow of new antibiotics dries up, and microbes that have become resistant to current drugs kill more people.
One of the latest suggestions is to copy the Netflix business model, i.e. to charge a subscription and the purchaser (governments, hospitals, health insurers) can get as much or as little of the drug as they want. So, the producers get a certain and consistent income, incentivising them to develop new treatments. It may sound odd, but the model is now being used in America for drugs to fight hepatitis C.
Source: The Economist magazine
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