用退款激励窄谱抗生素的开发

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摘要翻译：
抗生素耐药性的迅速上升是对全球公共卫生的严重威胁。如果没有进一步的激励措施，制药公司对开发抗生素没有什么兴趣，因为成功的可能性很低，开发成本很高。这种情况因“抗生素困境”而加剧：开发抗耐药细菌的窄谱抗生素对社会最有利，但对公司吸引力最小，因为它们的使用比广谱药物更有限，因此销售额很低。从研究任意数量抗生素的抗生素耐药性动态的一般数学框架出发，我们确定了有效的治疗方案，并引入了基于市场的退款计划，以激励制药公司开发窄谱抗生素：成功的公司可以从新成立的抗生素基金中要求退款，该基金部分支付其开发成本。建议的退款涉及固定和可变部分。后者（一）与用于此目的的其他新开发的抗生素相比，随着对目前耐药菌株使用新抗生素而增加--耐药溢价--和（二）随着对非耐药细菌使用这种抗生素而减少。我们概述了这种退款计划如何解决抗生素的困境，并应对抗生素研发中固有的各种不确定性来源。最后，将我们的退款方法与最近建立的抗微生物耐药性(AMR)行动基金联系起来，我们讨论了抗生素基金如何融资。
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英文标题：
《Incentivizing Narrow-Spectrum Antibiotic Development with Refunding》
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作者：
Lucas B\"ottcher and Hans Gersbach
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最新提交年份：
2020
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分类信息：

一级分类：Quantitative Biology        数量生物学
二级分类：Populations and Evolution        种群与进化
分类描述：Population dynamics, spatio-temporal and epidemiological models, dynamic speciation, co-evolution, biodiversity, foodwebs, aging; molecular evolution and phylogeny; directed evolution; origin of life
种群动力学；时空和流行病学模型；动态物种形成；协同进化；生物多样性；食物网；老龄化；分子进化和系统发育；定向进化；生命起源
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一级分类：Economics        经济学
二级分类：General Economics        一般经济学
分类描述：General methodological, applied, and empirical contributions to economics.
对经济学的一般方法、应用和经验贡献。
--
一级分类：Quantitative Finance        数量金融学
二级分类：Economics        经济学
分类描述：q-fin.EC is an alias for econ.GN. Economics, including micro and macro economics, international economics, theory of the firm, labor economics, and other economic topics outside finance
q-fin.ec是econ.gn的别名。经济学，包括微观和宏观经济学、国际经济学、企业理论、劳动经济学和其他金融以外的经济专题
--

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英文摘要：
  The rapid rise of antibiotic resistance is a serious threat to global public health. Without further incentives, pharmaceutical companies have little interest in developing antibiotics, since the success probability is low and development costs are huge. The situation is exacerbated by the "antibiotics dilemma": Developing narrow-spectrum antibiotics against resistant bacteria is most beneficial for society, but least attractive for companies since their usage is more limited than for broad-spectrum drugs and thus sales are low. Starting from a general mathematical framework for the study of antibiotic-resistance dynamics with an arbitrary number of antibiotics, we identify efficient treatment protocols and introduce a market-based refunding scheme that incentivizes pharmaceutical companies to develop narrow-spectrum antibiotics: Successful companies can claim a refund from a newly established antibiotics fund that partially covers their development costs. The proposed refund involves a fixed and variable part. The latter (i) increases with the use of the new antibiotic for currently resistant strains in comparison with other newly developed antibiotics for this purpose---the resistance premium---and (ii) decreases with the use of this antibiotic for non-resistant bacteria. We outline how such a refunding scheme can solve the antibiotics dilemma and cope with various sources of uncertainty inherent in antibiotic R\&D. Finally, connecting our refunding approach to the recently established antimicrobial resistance (AMR) action fund, we discuss how the antibiotics fund can be financed.
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PDF链接：
https://arxiv.org/pdf/2007.06468

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关键词：抗生素 Quantitative Mathematical Contribution Biodiversity 抗生素 resistant 治疗 确定 退款