A new report from Chatham House presenting suggestions for novel business models for antibiotics calls for models in which the return on investment in research and development is not dependent on the volume of sales, also known as delinkage.

According to the report from the Chatham House Working Group on New Antibiotic Business Models, a recent estimate shows that by 2050, the failure to address antibiotic resistance could cost 10 million premature deaths per year and US$ trillion in cumulative economic damage.

Few large pharmaceutical companies keep active antibacterial drug discovery programmes, because it is scientifically challenging and there are diminishing economic incentives.

The report, titled, “Towards a New Global Business Model for Antibiotics Delinking Revenues from Sales,” suggests that delinkage would help encourage investment in research and development. It would to this without also incentivising sales volumes, “which may lead to the over-marketing of antibiotics, acceleration of the development of resistance, and undermining of stewardship and conservation measures necessary to limit the growth of resistance to any new antibiotic developed.”

Among the recommendations on incentives, are the public funding of basic pre-clinical research, and partial public funding for clinical research through a combination of tax credits, contracts and prizes.

The report also advises against extensions of market exclusivity, as they are not considered “to be appropriate or effective as incentives for early-stage antibiotic development.”

The working group included representatives from academia, civil society, and industry, according to the report.

The report was edited by Charles Clift, senior consulting fellow in the Centre on Global Health Security at Chatham House; Unni Gopinathan, medical intern at Akeshus University Hospital and a PhD candidate at Oslo University Hospital; Chantal Morel, research officer at the London School of Economics; Kevin Outterson, professor of law and the N. Neal Pike scholar in Health and Disability Law at Boston University; John-Arne Røttingen, director of the Division of Infectious Disease Control at the Norwegian Institute of Public Health; and Anthony So, professor of the Practice of Public Policy and Global Health and director of the Programme on Global Health and Technology Access at Duke University’s Sanford School of Public Policy and the Duke Global Health Institute.

Image Credits: National Institute of Allergy and Infectious Diseases (NIAID)