Abstract
Background: Antimicrobial resistance (AMR) represents a significant global public health crisis. Despite ample availability of Gram-positive antibiotics, there is a distinct lack of agents against Gram-negative pathogens, including carbapenem-resistant Enterobacterales, which remains a real threat in Japan. The AMR Action Plans aim to mitigate the growing public health concern posed by AMR. Objective: This study aims to estimate the clinical and economic outcomes of drug-resistant Gram-negative pathogens forecasts for Japan to guide resource allocation defined within the upcoming National AMR Action Plan. Methods: A previously published and validated dynamic health economic model was adapted to the Japanese setting. The model used a 10-year time horizon with a willingness-to-pay threshold of ¥5 000 000 (US $46 827) and discounting was applied at a rate of 2% to costs and benefits. Clinical and economic outcomes were assessed as a function of varying AMR levels of three Gram-negative pathogens in Japan by up to 100% of the current level. Results: Reducing drug-resistant Gram-negative pathogens in Japan has the potential to save 4 249 096 life years, corresponding to 3 602 311 quality-adjusted life years. The associated maximum clinical and economic gains were estimated at up to 4 422 284 bed days saved, up to 3 645 480 defined daily doses of antibiotics avoided, up to ¥117.6 billion (US $1.1 billion) saved in hospitalization costs, and a net monetary benefit of up to ¥18.1 trillion (US $169.8 billion). Discussion: Learnings from this study can be used by the Japanese government to help inform decision-making on the strategies that may be included in the upcoming National AMR Action Plan and facilitate allocation of the required budget. Conclusions: This analysis demonstrated the considerable economic and clinical value of reducing AMR levels of three Gram-negative pathogens in Japan and could be utilized to support the valuation of antimicrobial treatment and resistance in Japan and more broadly.
Highlights
Antimicrobial resistance (AMR) represents a significant global public health crisis and, with its increasing prevalence, treatment options available to patients infected with resistant pathogens become increasingly limited
The overall number of deaths attributed to AMR in Japan is not known, a recent study estimated that deaths due to bloodstream infections caused by two pathogens, methicillin-resistant Staphylococcus aureus and fluoroquinoloneresistant Escherichia coli exceed 8000 per year.[2]
These were selected because infections with gram-negative bacteria are highly problematic in terms of resistance development with UTIs, IAIs, and hospitalacquired pneumonia (HAP) being common among carbapenem-resistant Enterobacterales and multi-drug resistant P. aeruginosa (MDRP) infections in the Japan Medical Data Vision (MDV)
Summary
Antimicrobial resistance (AMR) represents a significant global public health crisis and, with its increasing prevalence, treatment options available to patients infected with resistant pathogens become increasingly limited. Each year 700 000 people die from AMR-related causes globally, a figure that is projected to rise to 10 million by 2050 at a cost of US $100 trillion dollars to the global gross domestic product if we do not take action.[1] the overall number of deaths attributed to AMR in Japan is not known, a recent study estimated that deaths due to bloodstream infections caused by two pathogens, methicillin-resistant Staphylococcus aureus and fluoroquinoloneresistant Escherichia coli exceed 8000 per year.[2] The threat of a rapid rise in resistance rates after the emergence of Coronavirus disease The AMR Action Plans aim to mitigate the growing public health concern posed by AMR
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