Bioethics Blogs

Zeke Emanuel May Not Be Right This Time: Increasing Costs Will Probably Not Slow Antibiotic Resistance

Ezekiel J. (Zeke) Emanuel,
MD, PhD, is chair of the Department of Medical Ethics and Health Policy at the
University of Pennsylvania. On May 30, 2016, the Washington Post published an
opinion piece by Dr. Emanuel titled “Want to Win $2 Billion? Create the Next

In the article,
Dr. Emanuel makes two key points: (1) the low cost of antibiotics may be one of
the principal factors that have led to doctors over-prescribing these drugs;
(2) the low cost of antibiotics with the resulting low rate of return on
investment for pharmaceutical companies dis-incentivizes drug manufacturers
from allocating more resources for the research and development of new
antibiotics to combat evolving “superbugs” (bacteria resistant to current
antibiotics). He offers ideas to help solve the problem including: (1)
mandating that all hospitals create antibiotic stewardship programs to monitor
antibiotic use within institutions; (2) require that all antibiotic
prescriptions written be reviewed to assure that the prescribing is warranted
according to national guidelines; (3) increasing the charges for antibiotics;
and (4) creating a $2 billion prize with additional taxes or surcharges to be
awarded to individuals or entities that develop new antibiotics to counter
identified microbial threats.

One should be very
careful in challenging any suggestions Dr. Emanuel might make – after all he is
an internationally recognized health policy and medical ethics expert – but in
this case I think he is mistaken about issues and that his ideas may have
unintended negative consequences that will make matter worse.

Decades years ago,
antibiotics were far more expensive than they are today.

The views, opinions and positions expressed by these authors and blogs are theirs and do not necessarily represent that of the Bioethics Research Library and Kennedy Institute of Ethics or Georgetown University.