The Forgotten $35 Billion U.S. Healthcare Problem


Forbes-Each year, more than 23,000 people die in the United States as a direct result of bacterial infections that are resistant to antibiotics–the equivalent of a Boeing 747 crashing each week. And the same can be said for Europe, which estimates that 25,000 lives a year are lost to resistant bacteria. Even worse, there are at least 2 million people in the U.S. each year who acquire serious infections by bacteria that are resistant to one or more antibiotics. Since 2000, the number of cases reported has more than doubled.

Further, it is projected that due to lost wages, hospital stays and premature death, the U.S. lost about $35 billion in 2008 to antibiotic-resistant infections. Sadly, there is no slowdown in sight, as more and more antibiotics lose their effectiveness each year. Even more devastating is that unlike other areas of healthcare, there are no races for cures, no movie star endorsements and no cute symbols to pin on a jacket. Which also means that funding is severely lacking, as is awareness–among both patients and clinicians. “Until we improve prescribing variability, this problem with bugs will continue to grow,” explains Dr. Brandon Palermo, an infectious disease specialist at ILUM Health Solutions, a new Merck HSS company that is helping hospitals fight back with innovative technology.


An illustration picture taken in Lille on May 7, 2017 shows pills, tablets, caplets and capsules of medicine. (PHILIPPE HUGUEN/AFP/Getty Images)

Because antimicrobials vary from antibiotics to antivirals to antifungals and antimalarials, understanding what they do can be hard for any lay person. Additionally, the broad range of antimicrobials makes prescribing them incorrectly very easy for any health provider. Add in how quickly things mutate and how much it costs to keep up, and before long it becomes easy to see why the financial incentive just isn’t there for large pharma companies to invest in antimicrobials. Nor is it easy for providers and patients to learn about the impact–or lack thereof–of those currently prescribed.


A Pervasive Problem

People are dying around the world every day because we aren’t moving fast enough, although institutions like the WHO recognize what a global health problem antimicrobial resistance has become, and encourage countries to continue working on new drugs. But here in the U.S., the incentives are not there. The crisis is exacerbated by extreme attrition in research and development, as well as Big Pharma exiting the market. In fact, only six of the top 50 drug companies in the world are still developing antimicrobials.

Because antibiotics have a very slow commercial uptake, they typically don’t achieve meaningful revenue until just before the expiration of their patent. Rapid resistance can also result in the discontinuation of sales before peak revenues are achieved. For these and other reasons, it is projected that 80% of antimicrobial products in development are being created by small companies. Cidara Therapeutics President & CEO Dr. Jeff Stein contends that “it costs just as much, and takes just as long, to develop a lifesaving antimicrobial drug as it does to develop an anticancer drug that may extend life by a few weeks or months. Because of the limited commercial opportunity for antimicrobial drugs, however, their sales are typically not sufficiently meaningful to a big pharma company and, consequently, they direct their resources to other, more lucrative areas. To a small company, however, those sales can be very meaningful.”