Send message to Authors

Paper short abstract

Prevailing pharmaceutical value regimes are failing to deliver much needed novel antibiotics. This paper investigates how EU pharmaceutical policy is being recalibrated to fix ‘market failure’, revitalize innovation and instantiate a particular vision of a good pharmaceutical economy.

Paper long abstract

How are pharmaceutical innovation regimes currently being problematized and reordered amidst multiple interpenetrating health crises? To tackle the growing threat of antibiotic-resistant bacteria, the EU is attempting to revitalize the R&D ecosystem through novel financial incentives. Few antimicrobial pharmaceuticals have been developed in recent decades due to their relative unprofitability, which has often been articulated as a ‘market failure’. Big pharmaceutical companies have almost entirely left the sector, and the remaining small and medium enterprises (SMEs) have no one to acquire them after they complete the early stages of drug development. This disrupts their usual, financialized business model. Industry representatives, activists, and academics have proposed numerous possible solutions to this innovation drought. In late 2025, the EU has announced the introduction of ‘pull’ incentives – funds awarded to companies that bring innovative antibiotics to market. Pull incentives are generally agreed to be an effective way of revitalizing the R&D ecosystem, but the specificities of their implementation remain hotly contested. Actors have debated how to design an effective incentive that ensures both drug access and responsible antibiotic use. This paper investigates these pull incentives as reconfigurations of the antimicrobial innovation ecosystem following different visions of a good pharmaceutical economy, through a mix of policy document analysis, conference ethnography at pharma industry gatherings, and qualitative interviews. This paper speaks to STS scholarship on valuation and assetization by arguing that the main incentive mechanism the EU ended up choosing stabilizes the financialized mode of drug development while more transformative policy options were discarded.