Antimicrobial Resistance Tackling the Gap in R&D Resources with Pull Incentives

The briefing identifies a critical gap in the antibiotic R&D pipeline caused by a broken business model where low returns on investment and the need for stewardship discourage private development. While 'push' funding supports early research, the authors argue that 'pull' incentives—which guarantee future revenue regardless of sales volume—are essential to bring new drugs to market while ensuring equitable access and responsible use.

• The traditional pharmaceutical business model fails for antibiotics because maximizing sales leads to increased resistance and sub-optimal health outcomes, while demand for new drugs is unpredictable as older, cheaper options are preferred.
• Antibiotic development is uniquely costly and risky; clinical trials account for 65% of the cost of bringing a drug to market, partly because identifying patients with drug-resistant infections for trials is difficult.
• There is a severe shortage of new antibiotics in development; only 16 candidates target the World Health Organization's most critical priority pathogens, and only about five are expected to reach the market.
• Existing 'push' mechanisms, such as research grants and public-private partnerships, are insufficient on their own because they primarily support early-stage research and do not provide the long-term commercial incentive needed for full commercialization.
• Pull incentives are superior to push funding for late-stage development because they only reward successful outcomes, ensuring that private firms continue to bear a fair share of the risk and maintain efficiency.
• Effective pull mechanisms can decouple profit from sales volume, which supports antibiotic stewardship and prevents the incentive to over-market drugs, while potentially improving global access through intellectual property transfers.
• The document recommends prioritizing outcome-based pull incentives, such as market-entry rewards (lump-sum payments) or insurance-based systems, over lego-regulatory incentives like market exclusivity.

APA

World Economic Forum (2018). Antimicrobial Resistance Tackling the Gap in R&D Resources with Pull Incentives. http://www3.weforum.org/docs/Antimicrobial_Resistance_pagers_2018.pdf

Chicago

World Economic Forum. Antimicrobial Resistance Tackling the Gap in R&D Resources with Pull Incentives. 2018. http://www3.weforum.org/docs/Antimicrobial_Resistance_pagers_2018.pdf.

Wikipedia

{{cite report |author=World Economic Forum |title=Antimicrobial Resistance Tackling the Gap in R&D Resources with Pull Incentives |date=May 2018 |url=http://www3.weforum.org/docs/Antimicrobial_Resistance_pagers_2018.pdf |access-date=23 October 2026 |via=Climate Insights Directory}}

BibTeX

@techreport{worldeconomicforum2018antimicrobial, author = {{World Economic Forum}}, title = {{Antimicrobial Resistance Tackling the Gap in R\&D Resources with Pull Incentives}}, institution = {World Economic Forum}, year = {2018}, month = may, url = {http://www3.weforum.org/docs/Antimicrobial_Resistance_pagers_2018.pdf}, urldate = {2026-10-23}, note = {Indexed by Climate Insights Directory} }