Antibiotic resistance has been increasing along with antibiotic use. However, the supply of new drugs to replace those rendered inefficient by resistance has dwindled, leading to concerns that we may soon lack efficient means to treat bacterial infections. Though the problem has received considerable interest, there are no signs that the situation is about to change. It is maintained that this is because the two objectives – preserving the efficiency of existing drugs and increasing the supply of new ones – are partly opposing. Hence, creating an incentive structure compatible with both of them is no easy task. Nevertheless, it is suggested that levying a fee on antibiotics, and earmarking the proceeds from this fee for subsidizing development of new antibiotics, could be an important step towards increasing incentives for better antibiotic stewardship while preserving incentives to develop new substances.

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