Today, Bloomberg News reported that “Deadly Staph Germs May Be Cured by Old, $1-a-Day Antibiotics.” It turns out that generic, World War II-era antibiotics are becoming “the newest weapon of choice in the fight against deadly, drug-resistant staph germs.”
Physicians have discovered that drugs costing less than $1 a day can be very effective when treating methicillin-resistant Staphylococcus aureus, known as MRSA. The bacteria, once found only in hospitals and nursing homes, recently made news by showing up in schools and gyms. Last month, MRSA was linked to the deaths of a student in New York and one in Virginia. Annually, more than 18,000 Americans are killed by MRSA.
The physicians who mounted the studies of the older drugs were funded by the federal government. Meanwhile, in the for-profit private sector, Bloomberg observes, “drug-makers are spending hundreds of millions developing medicines that cost more than $100 a day to treat advanced cases.”
But physicians know the older, cheaper drugs work. “We have used these
older drugs with success for years,” says Gregory Moran, one of the
study leaders. He is a professor of emergency medicine at the Olive
View-UCLA Medical Center in Sylmar, California, affiliated with the
University of California at Los Angeles.
The advantage of the older generics, Moran explains, is that bacteria
haven’t developed broad resistance to them. Thus, the medicines can
forestall complications that would require more expensive drugs, such
as Wyeth’s Tygacil, an antibiotic that won FDA approval in 2005 and
costs about $100 a day. A typical daily dose of Pfizer Inc.’s Zyvox, a
synthetic antibiotic used to treat MRSA, is two $60 pills, taken for a
duration of 10 to 14 days.
“We know the generics kill bacteria in a petri dish, and we know they
work in people,” Moran adds. “They are already in wide use. What we
don’t have for them are clinical trials.”
But now, thanks to federal funding, formal trials of the older drugs
will start next year, In August, the National Institutes of Health
awarded $19 million to a research group led by Moran at UCLA and to
another led by Dr. Henry Chambers III at the University of California
at San Francisco. They aim to show that two families of older
antibiotics—sulfa drugs, in use since the 1930s, and clindamycin, first
prescribed in the late 1970s –should win Food and Drug Administration
approval for MRSA.
Moran reports that the five-year trials will each include at least
1,200 emergency-room patients with skin or soft tissue infections. The
trials will confirm the effectiveness of what doctors who now use the
drugs are doing, and perhaps change behavior by encouraging other
physicians to use the less expensive generics.
The NIH provided the funding because it realizes that there is a “gap
in the current knowledge” about the older drugs and that “government
needs to step in when market conditions may discourage drug companies from filling in,” says Moran.[my emphasis]
According to Bloomberg, Dr. Anthony Fauci, director of the U.S.
National Institute of Allergy and Infectious Diseases, a division of
the NIH, confirms that the grants are intended to fill a vacuum left by
pharmaceutical companies. Drugmakers, he says, don’t have an economic
incentive to study drugs with expired patents or to develop antibiotics
that have limited market potential.
Fauci emphasizes that the older drugs “are a temporary stopgap.”
Sooner or later, “the microbes will develop a resistance to them, and
at the end of the day we’ll need permanent solutions.”
For-profit drug-makers are looking for those more permanent (and no
doubt expensive) solutions. In the meantime, the government is doing
what needs to be done to save lives—once again highlighting the
difference between the NIH and the private sector.
Drug-makers exist to generate earnings for their shareholders.
Legally, this is a publicly-traded corporation’s first responsibility.
Public health needs are a secondary concern. If what the public needs
isn’t profitable, pharmaceutical companies usually won’t work on it.
For government-run health agencies, by contrast, improving the health
of the public is a first priority.