Fighting antimicrobial resistance starts with focusing on patients

Today, antimicrobial resistance (AMR) is one of the greatest threats to global health. Bacteria are becoming resistant to antimicrobials faster than our industry is innovating new medicines to fight antimicrobial-resistant infections. 

Our Chief Executive Officer Christine Miller is on the executive committee for the Antimicrobial Working Group (AWG), a coalition committed to advancing public policy that tackles AMR head on. 

The goal? Ensure patients in need have access to the right innovative antimicrobials at the right time. 

In this Q&A, Christine talks about the challenges of AMR and the solutions that will drive innovation and better patient outcomes. 

Why is AMR such a critical issue?  

 “When a patient has a life-threatening bacterial infection, time is so critical. The longer it takes for that patient to receive the right antimicrobial, the less likely it is that they will recover. 

CEO Christine Miller

What happens with an infection caused by resistant bacteria, like CRE (carbapenem-resistant Enterobacteriaceae), is that the patient might receive an antimicrobial, and it doesn’t work. The bacteria survives, and the infection gets worse. The patient needs an innovative antibiotic developed to fight AMR infections. And that innovative antibiotic has the highest success rate when given to the patient at the right time. 

The problem is that current policies disincentivize hospitals to use innovative antimicrobials. So, they tend to use older, lower-priced drugs on patients, which may have safety issues or not be as effective for a resistant organism as an innovative antimicrobial would be. 

The knock-on effect is that patients are dying unnecessarily from AMR infections, particularly underrepresented groups, and there are fewer companies investing in the innovation we need to fight AMR.” 

What’s the long-term risk of AMR? 

“Over the long-term, if no action is taken, the risk is that we won’t have the innovative antimicrobials we need. With increased AMR, even minor infections could become life-threatening. Routine medical procedures could become nearly impossible to perform without significant risk of infection. There could be another pandemic, but instead of a viral pandemic like we saw with COVID-19, it could be bacterial. And, we won’t have the right antibiotics to fight that. 

Just like the COVID-19 pandemic disproportionately affected minority groups, we’d likely see similar results in a bacterial pandemic. Like many other health conditions, underrepresented communities have higher risk factors for AMR infections. 

We need constant innovation in the antimicrobial space to ensure we have the right medicines to fight AMR — now and in the future — and we need reform to ensure those antimicrobials are accessible to all patients who need them, when they need them.”

How is AWG taking action? 

“Our biggest focus right now is advocating for reform of hospital reimbursement policies.  

The current structure provides hospitals with a fixed reimbursement amount based on diagnosis code. So, the hospital receives a fixed amount regardless of the drug given to the patient. That means that when it comes to using new, innovative antibiotics, the hospitals are disincentivized to use them because they’re more costly. 

What we’re proposing is that payment for antibiotics is removed from that reimbursement model. That way hospitals won’t have a financial disincentive to use an innovative antibiotic.

So, there are two pathways we’re using to advocate for this policy change — there’s a regulatory path working with the Centers for Medicare & Medicaid Services, and there’s a legislative path advocating for the DISARM Act, which would provide for additional reimbursement outside of the Medicare payment system for new antimicrobial drugs. 

The DISARM Act was just reintroduced in the U.S. House of Representatives with bipartisan support, which is one big step toward legislation that will increase patient access to innovative antimicrobials. One of the ways we’ve been taking action is by meeting with members of Congress and educating them about AMR and the DISARM Act, and we’re continuing to do that work to gain support from members of both the House and Senate for this important legislation.  

There are other solutions to fight AMR that focus on supporting companies in this space and encouraging innovation, like the PASTEUR Act that was also recently reintroduced to Congress.

What we see as the most pressing need is providing patients access to currently available innovative antibiotics. Reforming hospital reimbursement policies is such a critical piece to drive better patient outcomes and create more health equity. By doing that, we’re simultaneously creating an environment that will entice companies to invest in the AMR innovation we need to address this global health threat.”