The effectiveness of an antibiotic diminishes with use, leading to judicious use that mitigates resistance but limits the market. Developing a single antibiotic can take over a decade and cost over $1 billion, with an estimated return on investment of -$50 million.
Many large biopharmaceutical companies have dropped out of antibiotic development, while small ones struggle to survive. Since 2017, nearly every company that developed antibiotics has either gone bankrupt, abandoned research, or been forced to sell.