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Reintroduction of PASTEUR Act to Combat Antibiotic-Resistant Infections

by Danielle Smith, Keystone State News Connection

May 12, 2023

A bipartisan group of lawmakers has reintroduced the PASTEUR Act in Congress, which stands for Pioneering Antimicrobial Subscriptions to End Upsurging Resistance.

The legislation would encourage investment in the development of drugs to address what some have called “the antimicrobial resistance crisis.” It also aims to improve the appropriate use and availability of antibiotics.

David Hyun, antibiotic resistance project director for The Pew Charitable Trusts, said antibiotic resistance is due to not having enough new antibiotics coming to the market in the last couple of decades. He added the antibiotic pipeline has been pretty dry, compared with where things were about three or four decades ago.

“This is a problem because our antibiotic arsenal has not been able to keep pace with the emergence of antibiotic resistance that we’re seeing in patients,” Hyun explained.

Hyun emphasized the PASTEUR Act is creating an economic incentive for the drug-development pipeline, to incentivize and make sure new antibiotics are being researched and developed and filling unmet needs and space of antibiotic resistance.

Cornelius Clancy, professor of medicine at the University of Pittsburgh, said a key component of the bill is to establish a subscription-style model for antibiotics. He pointed out the Department of Health and Human Services will pay for access to a given new drug which is active against antibiotic-resistant pathogens, and provide drugs to health care systems. Reimbursement to companies developing drugs will not be on a per-use basis for the use of the drug.

“So this model attempts to come up with a new way of reimbursing for antibiotics where people will purchase — or systems will purchase — access to the drugs,” Clancy noted. “And then they can use them as often or as little as they like, and companies are not dependent upon dose-by-dose reimbursement.”

Clancy stressed it takes 10 to 20 years to develop a new antibiotic for the pipeline. He added some new antibiotics introduced and reaching clinics over the past 20 years have almost without exception, failed economically. Therefore, companies have either left or chosen not to get into the antibiotic drug development space.

“And the reason that’s important is we are seeing more and more resistant infections that we need new antibiotics for,” Clancy cautioned. “That trend is only going to increase in the future.”

Clancy added without some sort of effort to spur antibiotic development and to improve the economic prospects, for companies attempting to develop antibiotics then the U.S. runs into the risk in the future of not having enough antibiotics to fight infection-causing bacteria.

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