June 5, 2019
DISARM Act Provides Framework Needed to Spur Antibiotic R&D, Protect Existing Drugs
The introduction of the Developing an Innovative Strategy for Antimicrobial Resistant Microorganisms -- DISARM -- Act -- by United States Senators Johnny Isakson (R-GA) and Bob Casey (D-PA) Tuesday represents an essential step toward addressing the growing threat of infections that are increasingly resistant to existing treatments. By improving critical Medicare reimbursement for antibiotics and promoting their appropriate use, the legislation has the potential to stabilize the antibiotics market, spur the development of new infection-fighting drugs, and preserve the effectiveness of existing medicines.
The Infectious Diseases Society of America provided guidance that informed the legislation, which will help to ensure that patients can access new antibiotics when they are clinically appropriate, require hospitals to establish antibiotic stewardship programs, and spur improved reporting of antibiotic use and resistance to more rapidly identify challenges and inform best practices.
These combined measures are urgently needed. As many as 162,044 people die from infections that are resistant to current medicines, making antimicrobial resistance the third leading cause of death in our country. Antimicrobial resistance also threatens medical advances, including cancer chemotherapy, and organ transplants that depend on effective infection fighting medicines. Antibiotic stewardship programs in health care settings have been demonstrated to play a pivotal role in ensuring appropriate antibiotic use and improving patient outcomes. Requirements for such programs in all hospitals will slow the development of resistance, but the need for new antibiotics, also, is immediate.
The limited and short duration of antibiotic use, however, has made research and development toward new antibiotics unrewarding and even unfeasible for many companies that cannot make returns on their investments. Nearly all large pharmaceutical companies have abandoned the pursuit of new antibiotics, leaving about 80% of antibiotic research and development in the hands of small companies. Within the last year, one of the few remaining small antibiotics companies has declared bankruptcy, while another announced massive layoffs.
Allowing higher reimbursement for new antibiotics, requiring hospitals receiving increased payments for the drugs to monitor their use, report data to the U.S. Centers for Disease Control and Prevention, and establish stewardship programs, the DISARM Act reflects the value of safe, effective infection-fighting medicines to nation’s health. As a society of infectious diseases care providers and scientists we will continue to push for the passage of this crucial legislation, as well as for continuing efforts to promote appropriate antibiotic use, and build the pipeline of new antibiotics.