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Bug/drug resistance. Sometimes less is more
1Public Policy Analysis Program, University of Rochester, NY 14627.
Abstract:
Increased use of antibiotics in any community increases the risks that future bacterial strains will resist the effects of current antibiotics. The consequences of a resistant bacterial strain include costs for more expensive and powerful drugs, additional hospital days, and on rare occasion, death. A key to understanding the importance of this problem is better knowledge about the rate that resistance increases and persists as antibiotic use rates increase. Using the scant evidence available in the literature, this study conducts a sensitivity analysis to calculate the unrecognized costs of antibiotic use annually in the United States under various possible circumstances. For the estimated 150 million annual antibiotic prescriptions, the unrecognized costs appears to be at least $.1 billion, and they may exceed $30 billion in the worst case. The estimates of the burden caused by bacterial resistance to antibiotics depend heavily on unknown parameters, including the rate that resistance occurs, the dose-resistance patterns through time, the frequency of inappropriate use of antibiotics, and the frequency with which death occurs due to a resistant bacterial infection. New studies in each of these areas are needed to improve our understanding of the extent of the resistance problem.
Insights
Antibiotic resistance poses a significant threat, increasing healthcare costs and potentially leading to death. This study estimates the unrecognized costs of antibiotic use in the U.S. could range from $0.1 billion to over $30 billion annually.
Area of Science:
- Public Health
- Infectious Diseases
- Health Economics
Background:
- Increasing antibiotic use drives the emergence of resistant bacterial strains.
- Antibiotic resistance leads to higher medical costs, prolonged hospital stays, and mortality.
- Understanding the rate of resistance increase is crucial for public health policy.
Purpose of the Study:
- To estimate the unrecognized annual costs associated with antibiotic use in the United States.
- To perform a sensitivity analysis using available literature data on antibiotic resistance.
- To highlight the economic burden of antibiotic resistance.
Main Methods:
- Sensitivity analysis based on existing literature.
- Estimation of unrecognized costs for 150 million annual antibiotic prescriptions.
- Modeling under various potential scenarios for resistance development.
Main Results:
- Unrecognized costs of antibiotic use are estimated to be at least $0.1 billion annually.
- In worst-case scenarios, these costs could exceed $30 billion per year.
- Estimates are highly dependent on unknown parameters like resistance rates and inappropriate use.
Conclusions:
- The economic impact of antibiotic resistance is substantial and largely unrecognized.
- Further research is needed on resistance rates, dose-response patterns, and inappropriate antibiotic use.
- Improved data is essential to accurately assess and address the antibiotic resistance crisis.