Novel insights from financial analysis of the failure to commercialise plazomicin: Implications for the antibiotic investment ecosystem

Novel antibiotics are needed to combat multi-drug resistant bacterial strains, but most small and medium-sized biotechnology enterprises (SMEs) have gone bankrupt or exited at a loss. This lack of empirical research on the financial vulnerabilities of SMEs is significant. Achaogen’s bankruptcy and plazomicin’s commercialization failure led to a perception that novel antibiotics have zero market value. This study suggests that SMEs need incentive payments to survive the commercialisation cashflow drought and restore investor confidence in the antibiotic SME development model. New market-based incentives are being proposed by the US, EU, Canada, and Japan, but these must support sustainable financial models for SMEs critical to novel antibiotic development.