5 years ago

Preserving the ‘commons’: Addressing the sustainable use of antibiotics through an economic lens

As the growth of antibiotic resistance is in large part due to the widespread use of antibiotics, every effort must be made to ensure their sustainable use. Aims This narrative review aims to assess the potential contribution of health economic analyses to sustainable use efforts. Sources The work draws on existing literature and experience with health economic tools. Content The study examines some of the weaknesses in the health, regulatory, and industry arenas that could be contributing to inappropriate or sub-optimal prescribing of antibiotics and describes how economic analysis could be utilized to improve current practice by comparing both costs and health outcomes in order to maximize societal wellbeing over the longer-term. It finds that economic considerations underpinning current antibiotic prescribing strategies are incomplete and short-termist, with the result that they may foster suboptimal use. It also stresses that perverse incentives that drive antibiotic sales and inappropriate prescribing practices will need to be dis-entangled for sustainable use policies to gain traction. Finally, payment structures can be used to re-align incentives and promote optimal prescribing and sustainable use more generally. In particular eliminating or altering reimbursement differentials could help steer clinical practice more deliberately towards the minimization of selection pressure and the resulting levels of antibiotic resistance. Implications This work highlights the need for appropriately designed cost-effectiveness analyses, incentives analysis, and novel remuneration systems to underpin sustainable use policies both within and beyond the health sector.

Publisher URL: www.sciencedirect.com/science

DOI: S1198743X17304275

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