The PASTEUR Act: ‘Building Momentum, Creating a Stronger Sense of Urgency’

Earlier this month, the Pioneering Antimicrobial Subscriptions to End Upsurging Resistance (PASTEUR) Act was reintroduced in Congress. This is the fourth time the bill has been introduced, and if it passes, the federal government could enter into subscription-style contracts with pharmaceutical companies, providing fixed annual payments for access to critically needed antimicrobials, regardless of how often they are used.

PASTEUR has included improvements including its methodology for determining which drugs qualify for federal contracts to ensure the bill delivers new treatments.

“We really wanted to make sure that the bill would deliver the drugs that patients most urgently need, that there was as strong of a guarantee as possible to make sure that the drugs that get past our contracts really are drugs that are truly innovative and truly going to make a difference for patients,” said Amanda Jezek, senior vice president, Public Policy and Government Relations at Infectious Diseases Society of America (IDSA). Jezek leads a team at the organization that has been working on the bill for years and understands the bill uniquely. “So what the bill would do now is direct HHS [Health and Human Services] to develop an objective scoring methodology, and the scores that a drug would get, would determine, are they eligible for a contract, and how big is that contract going to be?”

Payments would be tied to a treatment’s impact in 3 areas: major contributions to patient care, innovation, and benefit to health systems and public health.¹ Jezek explains the categories within the methodology will include important questions to decipher if they qualify for the subscription program, such as:

• Is this therapy going to give better patient outcomes with less toxicity?
• How innovative is this drug? Is it first in class? Does it have a novel mechanism of action?
• How big of a difference is this drug going to make to our health care systems and to public health? Is this a treatment that is easier to store to get out into rural areas and other under resourced communities?
  

Another newer feature within Pasteur is the expansion of the antimicrobial stewardship provisions that now include outpatient settings.

“PASTEUR has always had a provision that provides grants to rural hospitals critical access hospitals and long-term care facilities to help support their stewardship programs,” Jezek said. “But the new bill, in addition to that, has a new pilot program to look at stewardship in the outpatient setting. This is so exciting and important because a lot of antibiotic prescribing happens in outpatient settings, but they don't really have the same level of infrastructure yet that inpatient settings have to really guide that optimal use. So, this pilot program will help start putting that infrastructure in place, and help us to then really study how it works and develop recommendations for a more widespread approach to stewardship in the outpatient setting.”

Jezek and other interested stakeholders in the bill have long advocated for PASTEUR, and see a common healthcare need that can benefit everyone.

“I think it's so important for people to understand the cost of doing nothing. Because, you know, it is true that if we want to invest in antibiotic development and antimicrobial stewardship, of course, that's going to cost some money, but we're already spending a lot of money dealing with AMR [antimicrobial resistance],” Jezek said. “We're spending billions of dollars every year in our health care system dealing with these horrible, drug-resistant infections. We want to spend money in a much smarter way. A way that's going to keep people healthier; that's going to keep them out of the hospital; or get them out of the hospital more quickly; a way that's going to save lives. And that's what PASTEUR is all about.”

Reference
1.Newly introduced legislation provides pathway to spur antimicrobial development. IDSA press release. Updated February 4, 2026. Accessed February 5, 2026.
https://www.idsociety.org/news--publications-new/articles/2026/newly-introduced-legislation-provides-pathway-to-spur-antimicrobial-development/