The demise of the antibiotic pipeline: the Bayer case

Antibiotics, celebrated as symbols of scientific triumph and societal advancement, have played a critical role in combating infectious diseases. However, their overuse has inadvertently fueled the emergence of antibiotic resistance. The primary strategy to tackle the resistance has been to develop new antibiotics. However, since the 1980s, there has been a noticeable downturn in the development of new antibacterial drugs. This slump, often referred to as the 'dry antibiotic pipeline', was particularly prevalent during the 1990s and aligned with that; many major pharmaceutical companies exited the antibiotic field in the early 2000s. That is also the main timeframe this paper focuses on. This work analyzes the dry antibiotic pipeline as a historical phenomenon and sets the stage by outlining the narrative context and key actors involved. It then discusses critical elements such as the understanding of innovation, scientific advances, regulatory requirements for clinical trials, and commercial models. These elements were often considered factors explaining the difficulty of developing new antibiotics. Using the case of the pioneering German company Bayer, these elements are brought together to illustrate the complexity of the crisis in the research and development of antibiotics. The Bayer story provides new insights into the internal realities of the company and reveals a range of entangled and multilayered challenges, which ultimately resulted in Bayer abandoning its storied production of anti-infectives, particularly antibiotics, calling into question the common understanding of the dry antibiotic pipeline.