Antibiotic resistance has developed into a major public health concern due to the widespread prevalence of bacterial infections such as sepsis and urethritis and the frequent occurrence of opportunistic infections in immunocompromised patients. Unfortunately, the pipeline for new antibiotics has been almost stagnant for more than three decades. The main reason is that the antibiotics R&D market is dysfunctional since antibiotic R&D is a very risky business model that is not profitable and attractive for investors under current market and policy conditions. Our work analyzes the main economic and policy challenges in antibiotic R&D and highlights the need of rapid action in developing new push and pull incentives. We suggest three core elements that aim to redesign the R&D market: (1) levying a fee on the nonhuman use of antibiotics, (2) using these revenues to pay for market entry rewards, and (3) rewarding companies for the development of new antibiotics that are effective against resistant bacteria (“the resistance premium”).