Antibiotic resistance has become a serious public health issue in Taiwan at a time when the nation could soon face the possibility of running out of effective antibiotics to treat infections, infectious disease experts said yesterday.
“The global threat of antibiotic resistance has impacted not only the international community, but also Taiwan,” Infection Control Society of Taiwan president Wang Fu-der (王復德) said at a press conference in Taipei.
He said more antibiotic drugs should be developed domestically or the domestic healthcare system should pay higher drug prices to entice foreign pharmaceutical companies to make their more advanced antibiotics available in Taiwan.
Photo: Chiu jou, Taipei Times
Although Wang was not able to quantify the current or near-term threat created by bacterial resistance to antibiotics, he cited studies estimating that antibiotic resistance could cause up to 33,000 deaths and economic losses of NT$300 billion (US$10.02 billion) in Taiwan in 2050.
One particular threat that has already arisen in Taiwan was carbapenem-resistant Enterobacteriaceae (CRE) group of bacteria commonly used in hospitals across the nation, Wang said.
CRE was one of the most critical threats that appeared on the WHO’s updated Bacterial Pathogen Priority List last year, he added.
Citing data from the Centers for Disease Control, Wang said that 30.3 percent of intensive care unit patients were infected with CRE in the third quarter of last year, up from 15 percent in 2015.
The rising figure, along with other indicators, showed that Taiwan is facing “a serious antibiotic resistance problem,” he said.
Infectious Diseases Society of Taiwan president Chang Feng-yee (張峰義) said that only a few antibiotics remain available as last-line treatment options in Taiwan, which are insufficient to meet clinical and patient needs.
Treating infections caused by multidrug-resistant bacteria requires new antibiotics, but Taiwan has fewer treatment options available compared with Western countries, which presents “a major challenge,” he said.
“Delayed treatment for drug-resistant bacterial infections can lead to higher mortality, with studies showing a sharp increase in death rates if appropriate antibiotics are not given within 72 hours,” Chang said.
Wang said the government should support local pharmaceutical companies in developing new antibiotics, as most are focused on generic drugs and lack the capacity for original antibiotic research and development.
Introducing new antibiotics developed overseas is also a solution, but Taiwan’s relatively low drug prices — mainly regulated by the National Health Insurance (NHI) system — have discouraged international drug companies from entering the Taiwanese market, he said.
“Taiwan is considered a relatively small market, so most companies prioritize entering the Chinese market first, where drug prices tend to be more favorable than in Taiwan,” he added.
Chang said that the NHI system is internationally known for its “strong bargaining power” with pharmaceutical companies, meaning it tends to drive down drug prices to maximize cost-effectiveness.
If pharmaceutical companies were to accept a low price in Taiwan, it could lead to pressure to lower prices in other countries as well, Chang said, adding that many companies are unwilling to bring new antibiotics to the Taiwanese market.
“Many companies would rather give up the Taiwanese market, which is why having reasonable NHI drug prices are so important,” he said.
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