Federal programmes like Medicare, which provides health care for the elderly,
often pay hospitals for antibiotics as part of bundled payments for hospitalisation, not as reimbursement for a particular treatment, as in the case of cancer.
Aleks Engel of Novo Holdings, another asset manager, cites this model as a perennial gripe among fellow investors in antibiotics.
Antibiotics which fall flat in the first few years can eventually become profitable,
notes Bibhash Mukhopadhyay of New Enterprise Associates,an American venture-capital firm.
美国风险投资公司New Enterprise Associates的Bibhash Mukhopadhyay说到。
Until tests pinpoint the specific bug causing an infection (which may take days),
doctors try several common antibiotics that usually work for the microbial culprit they suspect.
For example, when a first-line antibiotic stops working for most cases of pneumonia caused by bacteria
that grow in hospital patients' breathing tubes, the third-line antibiotic starts selling briskly.
Many investors are too impatient to wait that long. Lacking other products on the market to turn a profit,
firms like Achaogen struggle to raise capital to cover their costs.
Higher prices might help, but the debate in America is about how to lower the cost of drugs, not raise it.
Even if new antibiotics were paid for separately,
many investors think that patients for drugs like plazomicin are too few to make these drugs commercially viable in the near term.
Making them profitable for firms will take ingenuity.
This week a UN commission mused about granting large cash prizes for companies that create such drugs,
or paying them a subscription that guarantees fixed revenues regardless of use.
Given the x Prize and Netflix, these are at least familiar to venture capitalists.