[hristov]

Another reason why phages aren't used in western countries is that it is difficult to make money off of them. As I understand it, phages are bred uniquely for each strain which means it is difficult to patent them. The strains change all the time, therefore the phages have to change, by the time you get a patent for one, it is already likely to be ineffective.

Furthermore, the process of breeding phages for each disease is something drug companies really do not want to do. They want to manufacture pills, ship them in boxes to hospitals and get their money. Doesn't work with phages. You have to take samples at the hospital from a patient of the bacteria, breed a phage that eats that bacteria and then send that phage back to the patient.

This kind of back and forth seems way to expensive and complicated to the modern drug company. They do not want to build infrastructure around all the country's hospitals to ship contagious samples and to have labs all over the country to breed and manufacture phages.

[clnq]

I don't know how the economics can or would work out for a modern drug company. It's agreeable that Western personalized medicine seems to lag behind Europe and Asian countries like China.

However, this Georgian phage producer does sell patentable boxed-up phages that consume common bacteria, like S. aureus, which has been discussed for its antibiotic resistance in academia a lot - https://phage.ge/products/pyo-bacteriophage/?lang=en. Years ago, I stumbled across some online stores that used to sell these products in Europe and the US, but now I can't find them.

This makes me think that a traditional distribution model for these drugs can work. But there is too much medical skepticism for phage demand. And phages are often slower to work than antibiotics, so the latter option is more practical in treatment... when it works.