Lawmakers Reignite Effort to Fix Antibiotic Market with Revived PASTEUR Act

New proposal targets financial barriers slowing life-saving antimicrobial breakthroughs

By Gloria Lancer for Ravoke.com

A group of bipartisan lawmakers in the United States is reviving a long-running legislative effort aimed at solving one of modern medicine’s most pressing challenges: the lack of new antibiotics.

The PASTEUR Act—short for the Pioneering Antimicrobial Subscriptions to End Upsurging Resistance—has been reintroduced in the House of Representatives with the goal of reshaping how new antimicrobial drugs are funded. Although the bill has circulated in Congress since 2020, it has yet to advance to a full vote.

This latest version reflects both persistence from its backers and growing concern that the current system is failing to keep pace with the rise of drug-resistant infections.

A different way to pay for antibiotics

At the heart of the proposal is a shift away from the traditional pay-per-use model. Instead of tying revenue to how often a drug is sold, the federal government would establish subscription-style agreements with companies that develop high-priority antibiotics and antifungals.

Under this framework, drugmakers would receive guaranteed annual payments—potentially between $75 million and $300 million—based on factors such as how novel the treatment is, how much it improves patient outcomes, and its overall importance to public health.

The idea is simple: reward innovation and preparedness, not volume.

Why the current system isn’t working

Antibiotics occupy a unique and somewhat paradoxical space in medicine. They are essential, yet intentionally used sparingly to slow the spread of resistance. That reality makes them far less profitable than drugs designed for chronic conditions.

As a result, many large pharmaceutical companies have stepped away from antibiotic research altogether. Smaller biotech firms have tried to fill the gap, but even successful approvals haven’t guaranteed survival—several have collapsed financially despite bringing new drugs to market.

Meanwhile, antimicrobial resistance continues to escalate. Millions of infections in the US each year are now resistant to standard treatments, and tens of thousands of deaths are linked to those cases. Without intervention, the outlook is expected to worsen.

Supporters of the PASTEUR Act argue that without a predictable and sustainable financial model, the pipeline for new antibiotics will continue to thin at the worst possible time.

Bipartisan backing, renewed urgency

The bill is being championed by Representative Buddy Carter, alongside Representatives Scott Peters, Nick Langworthy, Mike Levin, and Mike Carey—an alliance that underscores its bipartisan appeal.

Backers say the legislation is not just about economics, but about national and global health security. Ensuring a steady supply of effective antimicrobials, they argue, is as critical as maintaining readiness for other public health threats.

What’s new in this version

While earlier versions of the PASTEUR Act drew support, they also faced criticism over complexity and oversight. The updated bill attempts to resolve those concerns with several notable revisions.

Clearer path for drug selection

A newly introduced scoring system is designed to bring more structure to how drugs qualify for federal contracts. Treatments will be evaluated on innovation, clinical impact, and public health value.

Only those that meet a minimum threshold will be eligible, and higher scores will translate into larger subscription payments. The goal is to make the process more transparent and easier for stakeholders to understand.

Broader focus beyond drug development

The revised legislation also expands its scope. It proposes the formation of an advisory committee made up of infectious disease specialists, antimicrobial resistance experts, and patient advocates to help guide implementation.

In addition, it introduces funding for pilot programs aimed at improving antibiotic stewardship in outpatient care—an area where overprescribing remains a persistent issue.

A wider lens on antimicrobial resistance

Supporters emphasize that the bill is not solely about incentivizing new drugs. It also reflects a broader strategy to address antimicrobial resistance as a systemic challenge—one that involves how antibiotics are developed, distributed, and ultimately used.

With resistance continuing to rise and the development pipeline under strain, the reintroduction of the PASTEUR Act signals that lawmakers are not ready to abandon the effort. Whether this version gains the traction previous attempts lacked remains to be seen, but the stakes are only getting higher.

FAQ

What is the PASTEUR Act?

The PASTEUR Act is proposed US legislation designed to encourage the development of new antibiotics and antifungal drugs. It aims to do this by changing how pharmaceutical companies are paid, shifting from sales-based revenue to fixed government payments.

Why is antibiotic development declining?

Antibiotics are typically used for short periods and are often reserved for severe or resistant infections. This limits sales and profitability, making them less attractive for pharmaceutical companies compared to long-term treatments for chronic conditions.

How does the subscription payment model work?

Instead of earning money based on how much of a drug is sold, companies would receive annual payments from the government. These payments would be based on how innovative and medically valuable the drug is, rather than its sales volume.

What problem is the bill trying to solve?

The legislation targets antimicrobial resistance (AMR), a growing global health threat where bacteria and other microbes become resistant to existing treatments, making infections harder to treat.

What changes were made in the latest version of the bill?

The updated version includes a scoring system to evaluate new drugs, improved transparency in how contracts are awarded, the creation of an expert advisory committee, and expanded support for antibiotic stewardship programs.

Has the PASTEUR Act been passed?

No, the bill has been introduced multiple times since 2020 but has not yet been passed into law or received a full vote in Congress.