Economic issues related to antimicrobial resistance

Abstract

Abstract The rise of antimicrobial resistance in recent times poses a serious threat to our ability to treat infectious diseases successfully (Cohen 1992; Levy 1992; Office of Technology Assessment 1995). Selection pressure resulting from increasing antimicrobial use has been identified as a primary causal factor, and is strongly influenced by the behaviour of individuals and institutions. More specifically, this increase is blamed on the overuse and misuse of antimicrobials by patients, physicians and the farm animal industry. From an economic perspective, antimicrobial resistance is a result of the absence of sufficiently strong incentives for individuals, physicians and drug manufacturers to consider the cost of resistance associated with antimicrobial use (Laxminarayan 2003). In this chapter, an economic perspective is used to characterize the resistance problem in both hospital and community settings, and to describe policy responses to encourage judicious use of antimicrobials. Incentives faced by patients, physicians, hospital administrators and the pharmaceutical industry with respect to antimicrobials are discussed.