An economic perspective on policy to reduce antimicrobial resistance

https://doi.org/10.1016/S0277-9536(97)00132-9Get rights and content

Abstract

Resistance to antimicrobial drugs is increasing worldwide. This resistance is, at least in part, associated with high antimicrobial usage. Despite increasing awareness, economists (and policy analysts more generally) have paid little attention to the problem. In this paper antimicrobial resistance is conceptualised as a negative externality associated with the consumption of antimicrobials and is set within the broader context of the costs and benefits associated with antimicrobial usage. It is difficult to determine the overall impact of attempting to reduce resistance, given the extremely limited ability to model the epidemiology of resistant and sensitive micro-organisms. It is assumed for the purposes of the paper, however, that dealing with resistance by reducting antimicrobial usage would lead to a positive societal benefit. Three policy options traditionally associated with environmental economics (regulation, permits and charges) are examined in relation to their potential ability to impact upon the problem of resistance. The primary care sector of the U.K.'s National Health Service provides the context for this examination. Simple application of these policies to health care is likely to be problematic, with difficulties resulting particularly from the potential reduction in clinical freedom to prescribe when appropriate, and from the desire for equity in health care provision. The paper tentatively concludes that permits could offer the best policy response to antimicrobial resistance, with the caveat that empirical research is needed to develop the most practical and efficient system. This research must be conducted alongside the required epidemiological research.

References (37)

  • J. Coast et al.

    Priority Setting: The Health Care Debate

    (1996)
  • J. Coast et al.

    Superbugs: should antimicrobial resistance be included as a cost in economic evaluation?

    Health Economics

    (1996)
  • P.G. Davey et al.

    Growth in the use of antibiotics in the community in England and Scotland in 1980–1993

    British Medical Journal

    (1996)
  • R.G. Evans

    Strained Mercy: The Economics of Canadian Health Care

    (1984)
  • L. Garrett

    Mutating microbes

    Independent

    (1995)
  • D.A. Goldmann et al.

    Strategies to prevent and control the emergence and spread of antimicrobial resistant microorganisms in hospitals

    A challenge to hospital leadership

    Journal of the American Medical Association

    (1996)
  • M. Grossman

    The Demand for Health: A Theoretical and Empirical Investigation

    (1972)
  • G.E. Halkos

    Economic incentives for optimal sulfur abatement in Europe

    Energy Sources

    (1995)
  • Cited by (0)

    View full text