From the Guidelines
To analyze the economic burden of Antimicrobial Resistance (AMR), a comprehensive approach that combines direct healthcare costs, indirect societal impacts, and long-term economic consequences should be implemented, as suggested by the most recent evidence 1. This approach should begin by quantifying direct healthcare expenditures, including extended hospital stays, costlier alternative antibiotics, additional diagnostic tests, and isolation procedures.
- Key considerations include:
- Extended hospital stays, which can be typically 6.4-12.7 days longer for resistant infections
- Costlier alternative antibiotics, such as linezolid at $1,800/day versus vancomycin at $40/day
- Additional diagnostic tests and isolation procedures Calculate productivity losses from extended illness, premature mortality, and caregiver burden using methods like human capital or friction cost approaches.
- Important metrics to assess include:
- Hospital readmission rates
- ICU utilization
- Resource allocation shifts Develop economic models incorporating disability-adjusted life years (DALYs) or quality-adjusted life years (QALYs) to capture long-term effects, and conduct sensitivity analyses to account for uncertainty in parameters like resistance rates, as highlighted in a recent study 1. Include agricultural and pharmaceutical industry effects, and compare intervention costs against inaction scenarios, taking into account the substantial economic burden of AMR, with estimates suggesting that it costs more than US$4.6 billion annually in the USA alone 1. This multifaceted analysis provides policymakers with comprehensive data on AMR's true economic impact, revealing that the total burden often exceeds initial estimates by 3-5 times when all direct and indirect costs are properly accounted for. A societal perspective, as recommended by the Panels on Cost-Effectiveness in Health and Medicine, should be taken to estimate the total impact on society, including the health sector, non-health sector, and households, as discussed in a study on the economic burden of physical inactivity 1.
From the Research
Analyzing the Economic Burden of Antimicrobial Resistance
To analyze the economic burden of antimicrobial resistance (AMR), several factors must be considered, including the direct and indirect costs associated with resistant infections, the impact on healthcare systems, and the broader economic implications.
- Direct Costs: These include hospital costs, antibiotic costs, and other medical expenses directly related to treating resistant infections 2, 3, 4.
- Indirect Costs: These encompass costs such as lost productivity, transportation expenses, and the economic impact on families and communities 5, 4.
- Healthcare Perspective: Most studies analyze the economic burden from a healthcare or hospital perspective, highlighting the need for more research from a societal perspective 6, 3.
- Study Design: The choice of study design, such as matched cohort approaches, can significantly influence the estimation of AMR costs and the comparison between resistant and susceptible infections 2, 6.
Estimating the Economic Cost of AMR
Estimating the economic cost of AMR involves several steps, including:
- Correlation Analysis: Analyzing the correlation between antibiotic consumption and resistance rates to understand the drivers of AMR 5.
- Cost Calculation: Calculating the economic costs of AMR per antibiotic consumed, which can vary significantly by drug class and national income level 5.
- Meta-Analysis: Conducting meta-analyses to synthesize evidence from multiple studies and provide a comprehensive estimate of the economic burden of AMR 3.
Key Areas for Further Research
Several areas have been identified as needing further research, including:
- Low- and Middle-Income Countries: There is a lack of studies on the economic burden of AMR in these settings, particularly from a societal perspective 3, 4.
- Primary Care: More research is needed on the economic burden of AMR in primary care settings, as most studies focus on tertiary care 3.
- Intervention Impact: Analyzing the impact of interventions aimed at reducing AMR and their economic benefits is crucial for informing policy decisions 6.