The heart of the problem with making a profit in the antibiotic business is the disconnect between the cost of the drugs and the revenue they can be expected to bring in. Much of the effort by government and non-profit actors is aimed at increasing that revenue potential. But what if you could dramatically reduce the cost of manufacturing?
Seattle, Washington-based Lumen Bioscience has an innovative approach to drugs that the company hopes will hit that sweet spot. Like LimmaTech, they’re focusing on prevention rather than treatment, but they also have a unique approach to the drugs themselves.
“We can price the product. That’s our trick,” Brian Finrow, Lumen’s CEO, told Deep Dive. “That’s our hack, the prevention versus treatment distinction. We make a product that is safe enough and cheap enough to use preventatively. Antibiotics are cheap enough, but not safe enough. Conventional biologics are safe enough, but not cheap enough. We got the good box in that two by two grid, and that means we can sell it at a price that saves the system money on net and still makes us a reasonable return. Neat trick, right?”
At the heart of the “trick” is a little organism called spirulina. You might have seen it in the grocery store where it’s sold as a dietary supplement. A single-cell photosynthetic microbe, spirulina, can be easily cultivated as a crop. Less easily, Lumen has found a way to engineer strains of spirulina to deliver therapeutic proteins, vastly reducing the price of creating biological drugs. In addition, because the pill is essentially a foodstuff, it has a very favourable safety profile, even at high doses.
On the AMR threat list, Lumen Bioscience is targeting Clostridioides difficile (C. diff), which the CDC puts on a short list of urgent threats when it comes to AMR. They are trialling it to prevent recurrence of C. diff in patients being treated with antibiotics.
“Antibiotics are a very broad spectrum, and so they kill off your microbiome,” Finrow explained. “That’s actually what opens up the opportunity for C. diff to recolonise. But the biologics have this attribute scientists call specificity, which means you can make them like a scalpel. They only go after the bad bugs and none of the others. Because they’re absorbed, in addition, you don’t have to worry about all the liver toxicity and other issues of antibiotics. They’re safer and much more specific. That’s why we can give them to you during the preventative phase, allowing your normal bacteria to regrow without risking another case of C diff.”
Not all of Lumen’s products are AMR-related. In fact, Finrow says, the company doesn’t brand itself as being in the AMR space precisely because of the stigma around profitability.
“Even if, as in our case, there’s a really compelling business case, it doesn’t matter because you can’t do research without funding,” he said. “The fact that everyone disagrees with us in the investor world that there’s a business case, it’s just it’s too bad. We get painted with a broad brush.”
Instead, they seek VC funding for other programmes, work with the US Department of Defense, CARB-X, and the Gates Foundation on their various AMR programmes, and hope that their strategy proves itself out in the long run.
“Preventive drugs, we think, are where we can operate,” he said. “We can’t solve all of the AMR crisis single-handedly. We’re not trying to. There are plenty of them that are systemic, and we don’t have a way to go after those. But for areas where we can operate, that’s our shot at proving all of the VCs wrong.”
