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The value of single-pathogen antibacterial agents

Nature Reviews Drug Discovery volume 12, page 963 (2013)Cite this article

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As noted by Lewis in a recent Review article (Platforms for antibiotic discovery Nature Rev. Drug. Discov. 12, 371–387 (2013))1, novel strategies for developing antibiotics are needed, as infections caused by multidrug-resistant organisms (MDROs) are a leading threat to public health2,3,4. Increasingly, industry, academia and regulators have become interested in the concept of relatively small development programmes focused on areas of high unmet need, such as single-pathogen therapies to treat highly resistant or totally resistant bacterial pathogens4,5,6,7. However, given the small number of cases affected per annum, how such agents could be valued to support development programmes has remained unclear.

To help clarify this issue, we estimated the annual incidence, cost and mortality of infections caused by one of the most concerning antibiotic-resistant pathogens: carbapenem-resistant Acinetobacter baumannii (CRAB). We then developed a cost effectiveness model to determine the cost per quality-adjusted life years (QALYs) saved at various costs with a novel, pathogen-specific agent targeting CRAB in comparison with the standard of care (Tables 1,2; see methods and references in Supplementary information S1 (table)).

Table 1 Model variables and sources
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Table 2 Cost-effectiveness sensitivity analysis
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Acknowledgements

This work was supported by US Public Health Service Grants R01 AI081719, R21 AI101750 and R21 AI101492.

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Authors and Affiliations

  1. Division of General Internal Medicine, Los Angeles Biomedical Research Institute, Harbor–UCLA Medical Center, Los Angeles, 90502, California, USA

    Brad Spellberg

  2. David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, 90095, California, USA

    Brad Spellberg

  3. AstraZeneca, 35 Gatehouse Drive, Waltham, 02451-1215, Massachusetts, USA

    John H. Rex

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  1. Brad Spellberg
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  2. John H. Rex
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Correspondence to Brad Spellberg.

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Competing interests

B.S. own equity in BioAIM, which is developing immunotherapies for infections. BioAIM provided no financial support for these studies. B.S.'s institute has received consulting fees on his behalf from GlaxoSmithKline, Pfizer, The Medicines Company, Meiji, Adenium, Cardeas, aRigen and Synthetic Biologics and research grants or contracts from Cubist, Pfizer, Esia and Bristol Myers Squibb. B.S. has received speaking honoraria from Cubist. J.H.R. is an employee of AstraZeneca Pharmaceuticals.

Supplementary information

Supplementary information S1 (table)

Methods and references for data (PDF 341 kb)

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Spellberg, B., Rex, J. The value of single-pathogen antibacterial agents. Nat Rev Drug Discov 12, 963 (2013). https://doi.org/10.1038/nrd3957-c1

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