Can an antibiotic user fee reduce resistance?

The Infectious Diseases Society of America recently released a list of policy suggestions aimed at combating the growing threat of antibiotic-resistant bacteria. One of their suggestions: Charge wholesale purchasers of antibiotics a user fee. Most of the money would go toward funding development of new antibiotics—something that Big Pharma doesn't pay much attention to, because it isn't terribly profitable. It's an interesting idea, and one that Maryn McKenna (a journalist who specializes in antibiotic-resistant superbugs) thinks has merit.

At the DC event, Dr. Brad Spellberg, author of Rising Plague (about resistance and drug development), likened the fee to something you'd pay at the gate of a national park. "We need to think of antibiotics as a precious, limited resource, the way we think of forests and fisheries — something we protect and restore," he said.

The interesting thing I see here: The proposed fee would be aimed at both medical and agricultural users. That's a big deal. As several people pointed out during the Conference on World Affairs, the routine use of antibiotics on healthy animals is a major contributor to antibiotic resistance. So is the unnecessary use of antibiotics by humans—who often take these bacteria-centric drugs in response to viral disease, such as colds. Maybe a user fee would discourage people from using precious antibiotics as placebos. Maybe a higher user fee for agricultural users would discourage the frivolous use of antibiotics, and force farmers to find safer ways of raising animals.