[zozbot234]

It's comparatively difficult to do applied research with grant funding, which is what most "publicly funded" universities tend to rely on. For this sort of high-value research, what you want is prizes so that success can be rewarded after the fact, even when the usual "market" mechanism of selling drugs is not working very well for whatever reason. Current policy approaches provide 'development incentives' of some sort as OP mentions, but clearly these are not enough.

[dv_dt]

Or crazy thought, expand the number and duration of grants to research this area...

[kryptiskt]

You can't rely on researchers to make a product out of their findings (running trials and getting approval) and that's were the big costs are.

[dv_dt]

One thing at a time, first uncover more promising avenues to antibiotics. Maybe they get private investment, maybe not, if not then go ahead and publicly fund the next stage.

None of this kind of thing stops say defense spending. We say hey our defense experts say we need x vehicle to defend our nation. Let's build x.

Our medical experts say we will need antibiotics in the future. It's a nice optimization perhaps to use crossover private profitability to fund the path to more drugs, but if the path isn't there privately, no one says, well we needed a new Aircraft carrier to defend the nation but none is available on the private market, oh well, guess we just live without.

[mattkrause]

Not in the current job climate, but if (say) successfully shepherding something through FDA approval were treated like a Nature paper, I bet you'd see a lot more researchers trying it.

The problem with the prize idea is that this stuff is expensive. Most academic institutions don't have a mechanism for doing something "on credit" and hoping to win a prize that covers the costs and then some. Some companies can, but the optics of giving prizes to BigPharma also aren't great.

[zozbot234]

> Most academic institutions don't have a mechanism for doing something "on credit" and hoping to win a prize that covers the costs and then some.

Some do, actually. It's called an "endowment". Unless by mechanism you meant an internal policy to allow for this - but that's the sort of stuff that can be changed with relative ease.

[mattkrause]

I chuckled a little at "relative ease" (nothing involving university legal stuff is easy) but ran some numbers to see how feasible that would be.

The median Phase II trial costs about $10M and has a 30% success rate; Phase III costs a lot more (say 2x that), but has better odds (58% advance to approval, and 85% of those get approved). Neglecting Phase I and everything before it, the expected cost is therefore about $16M (over ~3 years) and gets you an approved drug 15% of the time.

There are only 11 individual universities (plus three university systems) with endowments over $10B, but a surprising number with endowments in the $1B range. The draw rate on endowments is usually capped at 5% so that the principal remains intact, giving you around $50M for the entire university's endowment income.

A single trial would therefore consume about 10% of the endowment income per year--and with a 15% success rate, it's probably not going to win anything. There's no way a university president is going to let a group of researchers make a gamble like that.

[zozbot234]

That's precisely where the difference between grants and prizes would be clearest. If there is a big fat prize for, e.g. getting approval of a new antibiotic, people will be incented to push it through the pipeline.

That's the thing about applied research, in biotech/med and elsewhere: it doesn't get much interest from researchers, but the results are comparatively easy to evaluate for an uninvolved third party.