The challenge of antimicrobial resistance: What economics can contribute

Science         
05 April 2019  Vol 364, Issue 6435
http://www.sciencemag.org/current.dtl

Review
The challenge of antimicrobial resistance: What economics can contribute
By Laurence S. J. Roope, Richard D. Smith, Koen B. Pouwels, James Buchanan, Lucy Abel, Peter Eibich, Christopher C. Butler, Pui San Tan, A. Sarah Walker, Julie V. Robotham, Sarah Wordsworth
Science05 Apr 2019
Incentivizing restraint in drug use
The accelerating tide of antimicrobial resistance (AMR) is a major worldwide policy concern. Like climate change, the incentives for individual decision-makers do not take into account the costs to society at large. AMR represents an impending “tragedy of the commons,” and there is an immediate need for collective action to prevent future harm. Roope et al. review the issues associated with AMR from an economics perspective and draw parallels with climate change. A major stumbling block for both challenges is to build consensus about the best way forward when faced with many uncertainties and inequities.

Abstract
As antibiotic consumption grows, bacteria are becoming increasingly resistant to treatment. Antibiotic resistance undermines much of modern health care, which relies on access to effective antibiotics to prevent and treat infections associated with routine medical procedures. The resulting challenges have much in common with those posed by climate change, which economists have responded to with research that has informed and shaped public policy. Drawing on economic concepts such as externalities and the principal–agent relationship, we suggest how economics can help to solve the challenges arising from increasing resistance to antibiotics. We discuss solutions to the key economic issues, from incentivizing the development of effective new antibiotics to improving antibiotic stewardship through financial mechanisms and regulation.