Understanding the Economics of Microbial Threats Proceedings of a Workshop (2018) / Chapter Skim
Currently Skimming:
5 The Cost Dimensions of Antimicrobial Resistance
5 The Cost Dimensions of Antimicrobial Resistance
Pages 47-60
The Chapter Skim interface presents what we've algorithmically identified as the most significant single chunk of text within every page in the chapter.
Select key terms on the right to highlight them within pages of the chapter.
From page 47... ...
CONSIDERATIONS FOR ESTIMATING THE COST OF ANTIMICROBIAL RESISTANCE: DIRECT VERSUS INDIRECT COSTS Mukesh Chawla, advisor for health, nutrition, and population at the World Bank, discussed the methodologies and modeling results of the 47
|
From page 48... ...
Direct and Indirect Costs of Antimicrobial Resistance According to Chawla, AMR affects the economy through four channels that lead to either direct or indirect costs: increase in human mortality and morbidity, increase in livestock mortality and morbidity, and the "fear factor." Direct costs of AMR include health care expenditures and resources used to treat the disease, such as hospitalization expenses and medications. Indirect costs of AMR are derived from present and future costs to society from the loss of outputs caused by a reduced labor supply and lower productivity attributable to increased morbidity and mortality.
|
From page 49... ...
Projected costs are for three scenarios of AMR: Low case assumes 5 percent resistance rate, middle case assumes current resistance rate until year 15 and then 40 percent onward, high case assumes current resistance rate until year 15 and then 100 percent onward. SOURCES: Chawla presentation, June 12, 2018; Ahmed et al., 2017.
|
From page 50... ...
To calculate this, the modeling team derived the present values for the differences for GDP, exports, and extra health expenditures between the AMR scenarios and the base case at four social discount rates (see Table 5-1) .2 At the intermediate dis 2 A social discount rate is "typically used to derive a net present value as a summary mea sure of the effect of projects with streams of economic benefits and costs that are uneven over time" (Ahmed et al., 2017)
|
From page 51... ...
dollars) Social Discount Rate Scenario 0% 1.4% 3.5% 5.5% GDP Low case –40.4 –29.3 –18.7 –12.7 Middle case –74.5 –53.7 34.0 –22.7 High case –118.6 85.4 –53.7 –35.7 Exports Low case –10.8 –7.8 –5.0 –3.4 Middle case –19.9 –14.3 –9.0 –6.0 High case –31.7 –22.8 –14.3 –9.5 Household tax to finance extra health expenditure Low case 8.0 5.8 3.8 2.6 Middle case 14.8 10.7 6.8 4.6 High case 23.6 17.14 10.8 7.2 NOTE: GDP = gross domestic product.
|
From page 52... ...
Cost-Effectiveness of Efforts to Address Antimicrobial Resistance in OECD and European Union Countries Pearson described a cost-effectiveness analysis that used a dynamic microsimulation model to calculate the impact of AMR in OECD and 3 Machine learning approach is a method of data analysis that automates analytical model building, allowing computer systems the ability to learn from data, identify patterns, and make decisions, without explicit programming. Partial correlation measures the degree of association between two variables, while controlling or adjusting the effect of one or more additional variables.
|
From page 53... ...
By highlighting the probabilistic estimates of the interventions' likelihood of costeffectiveness and savings, Pearson stated that mass media campaigns and delayed prescription programs are associated with low costs but also have low levels of associated savings; meanwhile hand hygiene was associated with low costs and high savings. Improved hand hygiene demonstrated a 95 percent likelihood of being cost saving.
|
From page 54... ...
Antibiotics are crucial to address both, as many infectious diseases are not vaccine preventable and antibiotics represent the only treatment option, and for many chronic diseases antibiotics are part of the treatment approaches needed to control these diseases. The medical community's experience with antibiotics is relatively short -- antibiotic treatment was only discovered in the early 20th century -- and its experience with resistance to these drugs is even shorter.
|
From page 55... ...
He emphasized that current thinking around the benefits of new antibiotics is mainly focused on the health sector, but more analysis is needed to understand the effect of AMR on other sectors. He also noted that though funding for AMR response from the global community has risen over recent years, the majority of this funding goes toward antibiotic discovery.
|
From page 56... ...
Fukuda opened the discussion to the audience, starting with questions on the viability of specific interventions to reduce the threat of AMR. Mary Wilson, clinical professor of epidemiology and biostatistics in the School of Medicine at the University of California, San Francisco, asked about the potential benefit of vaccines as a prevention measure for both humans and livestock to reduce antibiotic use.
|
From page 57... ...
Laxminarayan noted that AMR has become an engine for many types of health interventions and is now tied to the universal health care agenda. Chawla stated that interventions taken from high-income countries to reduce AMR will be particularly difficult in countries with fragmented health systems, since the issue can be political, and it is difficult to manage prescriptions and antibiotic use by individual health care providers.
|
From page 58... ...
She asked how incentives can be created to unite interest groups to take society-level interventions to address AMR. Pearson responded that it is necessary to involve civil society to create social movements, and pointed out that some infectious diseases like HIV have strongly associated civil society embedded in the population.
|
From page 59... ...
He added that calculations relying on past AMR trends and costs of antibiotics do not necessarily translate to future costing estimates, as the role of antibiotics will likely evolve. Pearson argued that the numbers associated with the future cost of AMR (estimated to be as large as the global financial crisis)
|
Key Terms
This material may be derived from roughly machine-read images, and so is provided only to facilitate research.
More
information on Chapter Skim is available.