How do we save money on our prescription drug bill?

A New Year’s manifesto in the war on prescription drug waste

art.money image
Drug bust by Alan Cassels.

People ask Alan Cassels: how do we save money on our prescription drug bill?
His short answer is: do not pay for drugs:

  • that are higher cost drugs when there are lower cost drugs that are equally as effective.
  • that are the newest, most shiny drug when there is an older, safer equivalent.
  • which are useless.
  • with black box warnings if there are alternatives.
  • that have no proof they will actually help you.
  • that are likely to make a patient feel worse even if it makes your doctor or caregiver feel better to give it to you.
  • prescription-only when there are equally effective over-the-counter drugs.
  • that are likely to lead to additional problems, thus requiring more drugs to deal with the side effects of the drugs you’re currently taking.
  • when there are equally effective non-drug alternatives.
  • if they haven’t been tested or approved for the disease you have.
  • out of ignorance.
  • when you’re already taking too many.

Read The “12 Principles of Don’t Pay”, A New Year’s manifesto in the war on prescription drug waste, by Alan Cassels, commonground, 2015/01/12.

Une terrible épreuve, un livre sur le deuil périnatal

Mort et naissance, mort et renaissance. Un véritable hymne à la Vie

Mort et naissance, mort et renaissance.
Un véritable hymne à la Vie.

Tout se fige, le film de ma vie s’interrompt, comme la scène qui s’arrête dans un long métrage pour avertir que ce qui va suivre est capital. Arrêt sur image, juste pour me laisser le temps de déterminer sur quelle voie psychique je vais m’engager: la terreur, la résignation ou l’espérance.

Où étaient-ils? Ce n’était même plus un désir d’enfant qui m’animait, c’était une béance qui ne se refermait pas, un champ de bataille nettoyé de ses morts, qui gardait leur empreinte, un territoire de guerre complètement ravagé, un champ de désolation où seul le silence peut s’exprimer.

Un livre sur la mort? Certes, il y est question de parents endeuillés de trois bébés. Mais, à n’en pas douter, il s’agit avant tout d’un hymne à la Vie.

Ce récit raconte comment ces tout petits ont pris racine dans notre histoire et comment cela m’a permis de reprendre vie et de porter du fruit.

Ce récit est aussi un témoignage de mon cheminement avec Dieu dont je peux assurer qu’il m’a accompagnée tout au long de cette vallée sombre de la mort, même quand je ne le sentais pas. Pas de «grands» miracles, juste Ses pas à côté des miens.

En espérant contre toute espérance, Sophie a contribué à une véritable découverte anthropologique et législative: la dignité de la mort humaine avant la naissance.

Pasteur Serge Jacquemu.

Sources: uneterribleepreuve, Sophie Helmlinger.

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Le Distilbène DES, en savoir plus

Your doctor or therapist has confirmed it: you have depression. Now what?

To Treat Depression : Drugs or Therapy?

Your doctor or therapist has confirmed it: you have depression. Now what?

…” Until recently, many experts thought that your clinician could literally pick any antidepressant or type of psychotherapy at random because, with a few clinical exceptions, there was little evidence to favor one treatment over another for a given patient.

In fact, I used to delight in tormenting the drug company representatives when they asked me how I picked an antidepressant. I would take a quarter out of my pocket, flip the coin and say I’d let chance decide because their drug was no better or worse than their competitors’. “…

  • continue reading To Treat Depression, Drugs or Therapy? nytimes, JANUARY 8, 2015.
  • more info via Toward a Neuroimaging Treatment Selection Biomarker for Major Depressive Disorder, JAMA Psychiatry, August 2013.

Appel pour une opération mains propres sur la santé

Pour en finir avec les conflits d’intérêts. Pour réaliser 10 milliards d’euros d’économies en révisant la politique du médicament…

par Michèle Rivasi, Députée européenne #EELV #Greens. Fondatrice du @CRIIREM @CRIIRAD et @NTWeurope. Intérêt #santé #environnement #nucleaire #gazdeschiste #medicament.

Appel pour en finir avec les conflits d’intérêts, pour réaliser 10 milliards d’euros d’économies en révisant la politique du médicament. Par Michèle Rivasi, Députée européenne.

Notre République est victime d’une profonde crise démocratique et est sapée par la généralisation de la corruption qui met en péril notre État de droit. Ce phénomène se nourrit notamment de la banalisation des conflits d’intérêts, du lobbying institutionnel des multinationales et de la faiblesse des moyens de contrôle démocratique dans l’exécution des politiques publiques.

Un prix du médicament prohibitif en France

Il y a quelques mois nous avons appris que le laboratoire américain Gilead surfacture le Sovaldi (son médicament innovant contre l’hépatite C chronique de l’adulte) 256 fois son prix de revient. Or, en y incluant la recherche, ce prix est à l’évidence au moins dix fois plus élevé que le coût réel total. Les français sont les plus gros consommateurs de médicaments en Europe. Chaque année, les Français consacrent 2% du PNB à la consommation de médicaments. C’est entre 50% et 100% de plus que nos voisins les plus proches. En luttant contre cette sur-consommation et cette surfacturation par une meilleure prescription, l’assurance-maladie pourrait réaliser au moins 10 milliards d’économies c’est à dire annuler son déficit chronique et ce sans dommage pour la santé publique, bien au contraire.

En Italie, on constate que le coût des médicaments en ville et à l’hôpital s’élève pour 2013 à 18 milliards d’euros contre 34 milliards pour la France, soit 70% de plus à populations égales pour les mêmes résultats sanitaires (avec une espérance de vie de 7 mois supérieure en Italie). Les prix hors taxes des génériques sont supérieurs en France de 30% en moyenne à ceux pratiqués en Italie. De même, les génériques sont deux fois moins prescrits en France qu’en Angleterre, aux Pays-Bas ou en Allemagne car on préfère les « vrais-faux » nouveaux médicaments, beaucoup plus chers, sans plus-value thérapeutique, et à la pharmacovigilance méconnue car trop récente.

Le vrai risque aujourd’hui c’est une privatisation rampante du système de santé publique liée notamment à la dégradation du système hospitalier provoquant une inéquité de traitement et d’accès aux soins. Comment en sommes nous arrivés là? Parce qu’en France, la transparence ne règne pas dans le monde de la santé publique. Les intérêts privés viennent heurter l’intérêt général ; parce nous ne sommes toujours pas sortis de la collusion entre l’État et les groupes pharmaceutiques. D’ailleurs, les dernières affaires Cahuzac et le scandale du Médiator ont révélées ces situations de conflits d’intérêts au plus haut sommet de l’État.

Si nous en sommes arrivés là, c’est notamment à cause du poids des firmes pharmaceutiques dans la fixation des prix des médicaments. C’est l’État qui négocie avec les industriels le prix remboursable aux assurés sociaux de chaque médicament. Selon le discours de communication des laboratoires, les prix élevés sont indispensables pour couvrir le coût de la recherche. Mais la réalité est toute autre. Les laboratoires gonflent les chiffres en y incluant les dépenses de lobbying, de marketing, de communication et tout ce qui entretient le système de désinformation : les visites médicales, la formation médicale continue – financée à 98% par les labos – le sponsoring de la presse médicale, d’associations. Au final, la recherche coûterait 20 fois moins que ce que prétendent les entreprises. Ils continuent néanmoins à nous présenter comme révolutionnaires des médicaments qui ne le sont pas car le progrès thérapeutique est en panne depuis de nombreuses années (à l’exception du ciblage tumoral). Les laboratoires sont donc les premiers responsables de cette inflation du prix du médicament en France, mais aussi les autorités de régulation qui les adoubent, les médecins qui leur font une confiance aveugle, et surtout les politiques qui les choient, faisant de la surconsommation et la surfacturation de médicaments un soutien implicite à une filière industrielle. Le système entier est structurellement « pharma-amical ». Il est temps que ceux chargés de préserver l’intérêt général et la santé publique exercent leurs responsabilités.

Voyage au cœur des conflits d’intérêts

Il faut remonter les « liaisons dangereuses », qui n’ont fait que se développer (politiques, hauts fonctionnaires et labos) depuis l’origine de la mise en place du «système» soit le milieu des années 80, quand il est devenu difficile de trouver de nouvelles molécules. Depuis Claude Evin, tous les ministres de la Santé ont eu des liens soit antérieurs, soit postérieurs à leur exercice de la fonction avec l’industrie pharmaceutique. Il y a aujourd’hui nécessité d’une opération « coup de poing » telle l’opération Mains Propres («Mani Pulite») menée en Italie sur la décennie 82/92 dont les procédures se sont terminées en 2012 et qui ont permis d’assainir la situation notamment au niveau des conflits d’intérêts puisque tous les experts et leaders d’opinion des institutions ont subi enquêtes et condamnations. C’est un réseau extrêmement touffu et organisé qu’il faut démanteler, avec des intérêts énormes et qui concerne toute la vie politique et son financement.

Réformer en profondeur la politique du médicament

Il faut pour cela une réforme totale de la filière du médicament, avec :

  • Une lutte sans relâche contre les conflits d’intérêts. Pour cela, non seulement les élus et les experts qui représentent l’État face aux laboratoires, mais aussi tous les médecins, doivent rendre publics leurs liens avec l’industrie pharmaceutique. Il faut sanctionner plus durement les laboratoires qui ne déclarent pas leurs liens avec la formation des médecins avec l’instauration d’une pénalité à hauteur de 10% du chiffre d’affaire, qui nourrira la recherche publique et la formation des médecins.
  • Une refondation d’une expertise publique de qualité en revoyant le système obsolète des scientifiques qualifiés bénévoles.
  • La mise en oeuvre de la loi Blandin promulguée le 16 avril 2013 relative à l’indépendance de l’expertise en matière de santé et d’environnement et à la protection des lanceurs d’alerte.
  • Un arrêt des autorisations de mise sur le marché de complaisance, pour des médicaments sans plus-value thérapeutique et à prix prohibitifs.
  • Une purge des médicaments mis sur le marché qui ne servent à rien : seuls ceux qui ont un réel intérêt thérapeutique doivent être remboursés.
  • Une identification des médicaments présentant un fort intérêt public afin de permettre leur appropriation par l’État ; la logique sanitaire devant primer sur la logique commerciale ; il faut donc remplacer la notion d’« autorisation de mise sur le marché » par celle d’ « autorisation d’usage ».
  • Une complète transparence des coûts de recherche et de développement, et notamment des financements publics qui interviennent dans la recherche et le développement de nouveaux médicaments ensuite commercialisés par les firmes pharmaceutiques.
  • Une complète transparence également de la politique des brevets afin d’éviter que les monopoles qui ne devraient pas être accordés soient donnés à des firmes qui se trouvent ensuite en position d’imposer ensuite leurs prix.
  • Un « désarmement promotionnel » de l’industrie, par la restriction de son budget publicitaire et la réforme du système des visiteurs médicaux. Le déploiement des médicaments génériques passe en effet par l’évolution des visiteurs payés par l’industrie vers le métier d’ « informateurs pharmaceutiques indépendants ».
  • Une baisse générale des prix des médicaments et leur fixation à partir des données européennes et non plus de façon opaque comme actuellement par le CEPS (Comité économique des produits de santé) qui doit être profondément réformé.Pourquoi n’arrive-t-on pas à ce prix européen qui éviterait les dérives du contingentement constatées en Europe ?
  • Une optimisation de la prescription médicale dans toutes les classes thérapeutiques avec la généralisation des génériques et l’uniformisation européenne de leur prix.
  • La mise en place des Class Actions comme aux États-Unis ou en Italie pour protéger la population.
  • L’association des associations de patient, de victimes et de professionnels de santé à l’élaboration des standards d’évaluation des médicaments.
  • L’extension de l’obligation de pharmacovigilance à tous les professionnels de santé par des moyens simplifiés. Il convient de construire un mur parfaitement étanche entre les intérêts privés et la décision publique dans le domaine de la santé. Cette dernière doit être fondée uniquement sur l›intérêt général, la transparence et les principes qui fondent le service public pour les usagers : gratuité et égalité d’accès. Il est temps de renouer avec la disposition figurant au Préambule de notre Constitution : « La Nation garantit à tous (…) la protection de la santé ».
Sources et en savoir plus
  • APPEL – Opération “Mains propres sur la santé”,
    sur scribd et sur le site de Michèle Rivasi, 05 jan 2015.
  • Prix des médicaments : j’ai enquêté. Les génériques coûtent 30% plus cher en France, nouvelobs, 09-01-2015.

How Medical Care is being Corrupted

Your Medical Mind: How to Decide What is Right for You

Pamela Hartzband and Jerome Groopman are physicians on the faculty of Harvard Medical School and co-authors of “Your Medical Mind: How to Decide What is Right for You”.

” … financial forces largely hidden from the public are beginning to corrupt care and undermine the bond of trust between doctors and patients. Insurers, hospital networks and regulatory groups have put in place both rewards and punishments that can powerfully influence your doctor’s decisions… ”

Read How Medical Care Is Being Corrupted, NYtimes, NOV. 18, 2014.
Our posts tagged doctors and the pharmaceutical industry.

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Feeding Europe with Less Pesticides

Sustainable Agriculture; eliminate dependency on chemical pesticides and to support safe sustainable pest control methods as well as healthier products

Pesticide Action Network (PAN) was founded in 1982 and is a network of over 600 non-governmental organisations, institutions and individuals in over 60 countries worldwide working to minimise the negative effects and replace the use of harmful pesticides with ecologically sound alternatives.

Sources and more information

Pesticide Chlorpyrifos Risks to Workers, EPA Report

EPA is releasing an assessment for public comment on the potential for human health risk of the pesticide chlorpyrifos

EPA-background image
A pesticide used on corn and other U.S. crops poses health risks to workers who mix and apply it and also can contaminate drinking water, according to a new EPA report.

The US Environmental Protection Agency EPA is releasing an assessment of people’s risks from the pesticide chlorpyrifos for public comment. The assessment updates the June 2011 preliminary human health risk assessment based on new information including public comments. EPA factored in exposures from multiple sources and considered all populations in this revised assessment. The public comment period is expected to begin in mid-January, 2015 and will be open for 60 days.

What does EPA’s December 2014 human health risk assessment show?

This assessment shows some risks to workers who mix, load and apply chlorpyrifos pesticide products. When used in large amounts in small watersheds in certain geographic areas, chlorpyrifos also shows potential risks from drinking water. There were no additional risks from chlorpyrifos in food or exposure to bystanders and workers from airborne chlorpyrifos.

What are EPA’s next steps?

EPA is developing appropriate measures to ensure that workers that use or work around areas treated with chlorpyrifos are protected and that drinking water in vulnerable watersheds is protected.
As part of the ongoing registration review for chlorpyrifos, EPA is also assessing the ecological risks from chlorpyrifos in conjunction with the agency’s Endangered Species Protection Program; the results of the preliminary ecological risk assessment are expected later in 2015.

What is the registration status of chlorpyrifos?

Chlorpyrifos remains registered while it is undergoing registration review. Registration review ensures pesticides will not cause unreasonable adverse effects when used according to label directions and precautions and that there is a reasonable certainty of no harm from dietary and residential exposure. This revised human health risk assessment contributes to understanding how chlorpyrifos may affect humans, an important part of the registration review process.

How did EPA assess risks?

EPA assessed exposure from multiple sources including those from food, drinking water, pesticide inhalation and absorption of the pesticide through the skin for all populations, including infants, children and women of childbearing age. The assessment updates the June 2011 preliminary human health risk assessment based on new information received, including public comments and a new human response model.
This is one of the first risk assessments to employ a physiologically-based pharmacokinetic and pharmacodynamic (PBPK/PD) model. This is a mathematical model that enhances our ability to assess risk by allowing us to consider variations in a chemical’s effects on a person based on such variables as age and genetics and allows us to predict how the same dose may affect various members of a large population differently. EPA has held several meetings of the FIFRA Scientific Advisory Panels to get independent advice on the relevance and usefulness that a PBPK/PD model can provide in assessing a chemical’s risks and one specifically on PBPK/PD and chlorpyrifos.

Did EPA take into account the 10x safety factor specified under the Food Quality Protection Act to protect children?

Yes, EPA did retain the 10x factor for this risk assessment. EPA believes that the PBPK-PD model in conjunction with retention of the FQPA 10x safety factor is protective of children and other vulnerable populations.

Who is at risk for chlorpyrifos exposure?

We are concerned about some workers who mix, load and apply chlorpyrifos to agricultural and other non-residential sites. We are also concerned about workers who work around areas that are treated with chlorpyrifos, even if they are not using chlorpyrifos products as part of their jobs.

What would the signs or symptoms be for chlorpyrifos exposure?

At high enough doses chlorpyrifos can cause cholinesterase inhibition in humans; that is, it can impact the nervous system causing nausea, dizziness, confusion, and at very high exposures (e.g., accidents or major spills), respiratory paralysis and death. Anyone who exhibits these symptoms should seek immediate help from a local hospital, physician, or nearest poison control center.

Can chlorpyrifos affect wildlife?

Yes, and EPA has taken actions to help protect wildlife from chlorpyrifos exposure.
For example, many of the reported incidents of wildlife mortality associated with chlorpyrifos use were related to residential lawn and termite uses and use on golf courses. The residential uses have been eliminated, termiticide uses have been restricted, and the application rate on golf courses has been reduced. Additionally, no-spray buffers around surface water bodies, as well as rate reductions for agricultural uses further reduced the environmental burden of chlorpyrifos.
The agency is currently assessing the ecological risks for chlorpyrifos in conjunction with the agency’s Endangered Species Protection Program; the results of the preliminary ecological risk assessment are expected later in 2015.

What actions has EPA taken on chlorpyrifos?

The EPA has taken a number of actions that have limited the use of chlorpyrifos since 2000. These actions include:

  • In June 2000, the Agency eliminated all homeowner uses, except ant and roach baits in child resistant packaging.
  • In 2000, EPA required that all use of chlorpyrifos products in the United States be discontinued on tomatoes. The use on apple trees was restricted to pre-bloom and dormant applications. The grape tolerance was lowered to reflect the labeled dormant application.
  • In 2002, EPA restricted the use of chlorpyrifos on citrus and tree nuts as well other crops.
  • In 2012, EPA further limited the use of chlorpyrifos by significantly lowering pesticide application rates and creating “no-spray” buffer zones around public spaces, including recreational areas and homes.
Sources and more information
  • Revised Human Health Risk Assessment on Chlorpyrifos, EPA, January 5, 2015.
  • EPA Revised Chlorpyrifos Assessment Shows Risk to Workers,
    EPA press release, January 5, 2015.
  • EPA report finds pesticide poses risk to workers, spurs calls for ban, environmentalhealthnews, January 8, 2015.

 

Know Your Terms Initiative

Raising Awareness about the new full term pregnancy definition

Know Your Terms Initiative infocard image
Raising Awareness about the new full term pregnancy definition.
Watch @DES_Journal diaporama and health infographics album on Flickr.

Sources: The Know Your Terms Initiative, website and sharing information.

Sadly for many DES daughters having their own children is not possible! Many of us who have experienced miscarriages, want to have kids but are struggling or unable to… Find out more about DES pregnancy risks and studies about DES and pregnancy.

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Maker of world’s best-selling drug uses legal action to keep data secret

Paper via theconversation, 8 November 2013, written by Dr David Healy, professor of psychiatry and co-founder of data based medicine, operating through RxISK, working towards making medicines safer

Paper via theconversation, 8 November 2013, written by Dr David Healy, professor of psychiatry and co-founder of data based medicine, operating through RxISK, working towards making medicines safer.

clinical-data-files image
Opening the safe on safety data

In 2010, the European Ombudsman ruled that the European Medicines Agency should open access to clinical trials data when companies applied to get their drugs on the market. The ombudsman decided public health was more important than considerations of commercial confidentiality.

In February 2013, the US pharmaceutical company AbbVie, who make Humira – the best-selling drug in the world today – and another company Intermune independently took legal action against the EMA’s open access policy after they were tipped that competitors had requested access to clinical study reports and the EMA was going to grant it. In one of the most important healthcare legal actions ever taken, the court upheld the pharmaceutical companies’ positions.

Six months later, the European Federation of Pharmaceutical Industries and Associates (EFPIA), convened a meeting in Brussels to look at the issue of trial data access. Neal Parker, a senior legal figure within AbbVie, said it was in “the public health interest to maintain commercial confidentiality to drive business forward.

While “a vast amount of data was released without controversy”, he said, a competitive landscape meant that the remaining data had to be in the control of companies.

Adverse effects and Eastern threats?

However, Parker caused a stir by intimating that data on adverse drug reactions should be treated as commercially confidential – an unusual admission. To protect these and other data such as demographic information and lab results, the company were seeking corporate privacy rights.

But there was another little remarked intervention close to the middle of the meeting, when Richard Bergström, the EFPIA’s Director General, intervened to say that most of the organisation’s industry members were “quite relaxed” about data disclosure. For most products, apart from products in highly competitive fields such as biologics (products created using biological processes rather than synthesising chemicals and which include vaccines), there would be no issues. But Bergström added:

“You might get companies from South Korea or China breathing down your neck trying to copy your technology, then you get extra sensitive.”

This comment raises a question. While the commentariat have been debating access to clinical trial data in the media, is the action actually elsewhere and about something entirely different?

EMA licenses new rival

In September, a little over two weeks after this meeting, the EMA provisionally approved infliximab biosimilar (trade name Inflectra), an antibody drug for use in the same inflammatory diseases AbbVie’s Humira is used for: rheumatoid arthritis, Crohn’s disease and psoriasis.

Infliximab is the core compound in Remicade, another drug used to treat Crohn’s disease and rheumatoid arthritis and developed by Johnson & Johnson. Remicade was one of the first biologics or MABs (monoclonal antibodies) type of drugs, of which Humira has become the most famous.

The branded pharmaceutical industry has always fought hard against generic drugs which eat into their blockbuster profits and they have fought tooth and nail to stop “generic” versions of any of these biologics being launched based on the argument that no generic can be identical to its parent biologic.

There are in fact irreducible differences between all of the original MABs and derivative biologics. And this has given rise to the concept of the biosimilar, to which the new Inflectra belongs and which can be produced more cheaply. And the pipeline for new drugs is so poor that blocking biosimilars has become almost a life or death issue for the branded companies.

Cats in bags and spiralling costs

So where do Richard Bergström’s comments fit into all of this and did he let the cat out of the bag by mentioning Korea?

The newly approved Inflectra was made by Celltrion – a Korean company – working in collaboration with Hospira, a new kind of pharmaceutical company that has emerged to help develop biosimilars. Hospira, based in both the US and UK, is the first company to major on the market development of biosimilars. It filed the application to market Inflectra in America and Europe (and as Celltrion’s Remsima in other markets).

This could lead to the price of biologics, which can cost anywhere between $20,000 and $500,000 (£12,000 – £300,000) per year, falling dramatically: Inflectra will likely cost 33% less than Johnson & Johnson’s Remicade and will have knock on effects for Humira.

Margaret Chan, Director General of the World Health Organisation, said earlier this year:

The costs of many new medical products are becoming unsustainable for even the wealthiest countries in the world. [Of the 12 cancer drugs approved last year], 11 were priced above the $100,000 per patient per year. This price is unaffordable, for most patients, most health budgets and most insurance companies. These are problems for all countries, not just the developing world.

Before the MABs, big insurance companies like UnitedHealth Group, Humana and others simply paid out on new drugs. They offered a reimbursement rather than an insurance service. But now that biologics are so much more expensive than older drugs, companies in this area, especially larger companies, have had to become insurers rather than just reimbursers. And the development of biosimilars offers these insurance companies huge leverage. Companies like Hospira and Celltrion have a chance to change healthcare radically, but it involves competition – and perhaps a commercial threat from the East.

AbbVie was until recently Abbott Laboratories, one of the world’s biggest pharmaceutical companies, and wields significant power. Big pharma argue that protecting commercial interests protects their investment – and without it we wouldn’t have new drugs.

But while campaigners fight for more transparency over clinical trial data, and by extension information about adverse effects and risk that some medicines may pose, there is a two-fold problem which all this reveals: how commercial interests mean more expensive drugs and treatment potentially denied to those who desperately need it, despite us knowing that there may be a way to help.

The timing of AbbVie’s action against the EMA policy suggests that this was not really about transparency at all but about trying to deter the EMA from licensing Inflectra/Remsima, and a raft of cheaper, more available drugs. It was filed at a time when the threat it posed might still have played a part in the considerations of EMA or the politicians to whom EMA has to answer.

The European Court is due to deliver an initial judgement in the next few weeks on the decision to allow the trial data to be withheld. Transparency (and access to safety data) will be dealt a severe blow if AbbVie and Intermune triumph. And we may well also be worse off without cheaper competitive biosimilars on the market.

New antibiotic kills pathogens without detectable resistance, might help fight future superbugs

U.S. scientists have discovered a new class of antibiotics that can kill a wide range of dangerous, drug-resistant bacteria

bacterial colonies image
U.S. scientists have discovered a new class of antibiotics that can kill a wide range of dangerous, drug-resistant bacteria. Image via Lee Maguire.

Abstract

Antibiotic resistance is spreading faster than the introduction of new compounds into clinical practice, causing a public health crisis. Most antibiotics were produced by screening soil microorganisms, but this limited resource of cultivable bacteria was overmined by the 1960s. Synthetic approaches to produce antibiotics have been unable to replace this platform. Uncultured bacteria make up approximately 99% of all species in external environments, and are an untapped source of new antibiotics. We developed several methods to grow uncultured organisms by cultivation in situ or by using specific growth factors. Here we report a new antibiotic that we term teixobactin, discovered in a screen of uncultured bacteria. Teixobactin inhibits cell wall synthesis by binding to a highly conserved motif of lipid II (precursor of peptidoglycan) and lipid III (precursor of cell wall teichoic acid). We did not obtain any mutants of Staphylococcus aureus or Mycobacterium tuberculosis resistant to teixobactin. The properties of this compound suggest a path towards developing antibiotics that are likely to avoid development of resistance.

Sources and more information
  • A new antibiotic kills pathogens without detectable resistance, Nature (2015) doi:10.1038/nature14098, 07 January 2015 – full article.
  • A New Drug in the Age of Antibiotic Resistance, theatlantic, Jan 7 2015.
  • Antibiotics: US discovery labelled ‘game-changer’ for medicine,
    BBC News, 7 January 2015.
  • Revolutionary New Antibiotic Kills Drug-Resistant Germs,
    livescience, 7 January 2015.