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Manos Perros, President and CEO, Entasis Therapeutics

The new reality for next-gen antibiotics

Posted on 13/09/2019 by Manos Perros, President and CEO, Entasis Therapeutics

The future of antibiotic development lies in targeted approaches that can deliver novel drugs tailored to tackle those highly resistant pathogens with greatest medical need.

The world of antibacterial therapy as we know it is changing fast. For decades we have used antibiotics empirically, treating infections with little understanding of the pathogens responsible, often using powerful new antibiotics where an older drug, or perhaps no antibiotic at all, would have worked just as well. Today, mass-produced, broad-spectrum antibiotics are still prescribed to millions of patients. As a result, antibacterial resistance to many of those drugs is rising fast, threatening to undo a major healthcare revolution of the 20th century and send us back to a world in which patients can die from a scratch and many routine interventions, including surgery, chemotherapy or transplantation, once more become unthinkable.

The good news is that, for most patients, broad-spectrum drugs still work to save lives. But for those patients for whom these older drugs no longer work, disinvestment from R&D in antibiotics means treatment options are rapidly waning.

We’re not talking small numbers of people. In the United States alone, up to 200,000 people die every year from drug-resistant bacterial infections. For pathogens like Acinetobacter, resistance to mainstream antibiotics exceeds 80% in Southern and Eastern Europe with mortality as high as 50%.

Against this backdrop, treating patients indiscriminately with innovative antibiotics is no longer an option. Rather, we need to preserve new drugs for the patients who really need them. At Entasis, we focus on those patients and tailor our drugs to fight the multi-drug resistant bacteria with the highest medical need. We do so thoughtfully and responsibly, from discovery to clinical development and, if we are successful, commercialization.

We are inventing and developing pathogen-targeted products that will be more effective and safer for patients. But these will not be the high-volume, low-margin drugs that we have been used to in years past, and prescription and reimbursement practices are only now starting to adapt to this new reality.

In the United States, the country’s biggest reimbursement mechanism is being reformed to cover the excess costs incurred by hospitals when they use new antibiotic products. And the recently proposed DISARM Act aims to take that reimbursement outside the limitations of the current system altogether. The United Kingdom is also planning to test a value-based reimbursement model, while other countries are similarly considering reimbursement and distribution models that can improve access to life-saving antibiotics.

The transformation that we are witnessing is not unique to antibiotics. Personalized medicine, where treatments are tailored to well-defined patients, is very much the future. The biotech and pharmaceutical industries are rolling up their sleeves, and I am confident that there’s plenty of knowledge and know-how still in reserve waiting to spark much needed innovation.