TY - JOUR

T1 - A one health framework to estimate the cost of antimicrobial resistance

AU - Morel, Chantal M.

AU - Alm, Richard A.

AU - Årdal, Christine

AU - Bandera, Alessandra

AU - Bruno, Giacomo M.

AU - Carrara, Elena

AU - Colombo, Giorgio L.

AU - de Kraker, Marlieke E.A.

AU - Essack, Sabiha

AU - Frost, Isabel

AU - Gonzalez-Zorn, Bruno

AU - Goossens, Herman

AU - Guardabassi, Luca

AU - Harbarth, Stephan

AU - Jørgensen, Peter S.

AU - Kanj, Souha S.

AU - Kostyanev, Tomislav

AU - Laxminarayan, Ramanan

AU - Leonard, Finola

AU - Hara, Gabriel Levy

AU - Mendelson, Marc

AU - Mikulska, Malgorzata

AU - Mutters, Nico T.

AU - Outterson, Kevin

AU - Baňo, Jesus Rodriguez

AU - Tacconelli, Evelina

AU - Scudeller, Luigia

AU - the GAP-ON€ network

PY - 2020

Y1 - 2020

N2 - Objectives/purpose: The costs attributable to antimicrobial resistance (AMR) remain theoretical and largely unspecified. Current figures fail to capture the full health and economic burden caused by AMR across human, animal, and environmental health; historically many studies have considered only direct costs associated with human infection from a hospital perspective, primarily from high-income countries. The Global Antimicrobial Resistance Platform for ONE-Burden Estimates (GAP-ON€) network has developed a framework to help guide AMR costing exercises in any part of the world as a first step towards more comprehensive analyses for comparing AMR interventions at the local level as well as more harmonized analyses for quantifying the full economic burden attributable to AMR at the global level. Methods: GAP-ON€ (funded under the JPIAMR 8th call (Virtual Research Institute) is composed of 19 international networks and institutions active in the field of AMR. For this project, the Network operated by means of Delphi rounds, teleconferences and face-to-face meetings. The resulting costing framework takes a bottom-up approach to incorporate all relevant costs imposed by an AMR bacterial microbe in a patient, in an animal, or in the environment up through to the societal level. Results: The framework itemizes the epidemiological data as well as the direct and indirect cost components needed to build a realistic cost picture for AMR. While the framework lists a large number of relevant pathogens for which this framework could be used to explore the costs, the framework is sufficiently generic to facilitate the costing of other resistant pathogens, including those of other aetiologies. Conclusion: In order to conduct cost-effectiveness analyses to choose amongst different AMR-related interventions at local level, the costing of AMR should be done according to local epidemiological priorities and local health service norms. Yet the use of a common framework across settings allows for the results of such studies to contribute to cumulative estimates that can serve as the basis of broader policy decisions at the international level such as how to steer R&D funding and how to prioritize AMR amongst other issues. Indeed, it is only by building a realistic cost picture that we can make informed decisions on how best to tackle major health threats.

AB - Objectives/purpose: The costs attributable to antimicrobial resistance (AMR) remain theoretical and largely unspecified. Current figures fail to capture the full health and economic burden caused by AMR across human, animal, and environmental health; historically many studies have considered only direct costs associated with human infection from a hospital perspective, primarily from high-income countries. The Global Antimicrobial Resistance Platform for ONE-Burden Estimates (GAP-ON€) network has developed a framework to help guide AMR costing exercises in any part of the world as a first step towards more comprehensive analyses for comparing AMR interventions at the local level as well as more harmonized analyses for quantifying the full economic burden attributable to AMR at the global level. Methods: GAP-ON€ (funded under the JPIAMR 8th call (Virtual Research Institute) is composed of 19 international networks and institutions active in the field of AMR. For this project, the Network operated by means of Delphi rounds, teleconferences and face-to-face meetings. The resulting costing framework takes a bottom-up approach to incorporate all relevant costs imposed by an AMR bacterial microbe in a patient, in an animal, or in the environment up through to the societal level. Results: The framework itemizes the epidemiological data as well as the direct and indirect cost components needed to build a realistic cost picture for AMR. While the framework lists a large number of relevant pathogens for which this framework could be used to explore the costs, the framework is sufficiently generic to facilitate the costing of other resistant pathogens, including those of other aetiologies. Conclusion: In order to conduct cost-effectiveness analyses to choose amongst different AMR-related interventions at local level, the costing of AMR should be done according to local epidemiological priorities and local health service norms. Yet the use of a common framework across settings allows for the results of such studies to contribute to cumulative estimates that can serve as the basis of broader policy decisions at the international level such as how to steer R&D funding and how to prioritize AMR amongst other issues. Indeed, it is only by building a realistic cost picture that we can make informed decisions on how best to tackle major health threats.

KW - Antimicrobial resistance

KW - Cost

KW - One health

U2 - 10.1186/s13756-020-00822-6

DO - 10.1186/s13756-020-00822-6

M3 - Journal article

C2 - 33243302

AN - SCOPUS:85096806123

VL - 9

JO - Antimicrobial Resistance and Infection Control

JF - Antimicrobial Resistance and Infection Control

SN - 2047-2994

IS - 1

M1 - 187

ER -