TY - JOUR
T1 - Overcoming challenges in the economic evaluation of interventions to optimise antibiotic use
AU - on behalf of the STEPUP team
AU - Roope, Laurence S.J.
AU - Morrell, Liz
AU - Buchanan, James
AU - Ledda, Alice
AU - Adler, Amanda I.
AU - Jit, Mark
AU - Walker, A. Sarah
AU - Pouwels, Koen B.
AU - Robotham, Julie V.
AU - Wordsworth, Sarah
AU - Zalevski, Anna
AU - Yadav, Sara
AU - Wright, Carla
AU - Tonkin-Crine, Sarah
AU - Moore, Michael
AU - McLeod, Monsey
AU - Majeed, Azeem
AU - Hopkins, Susan
AU - Holmes, Alison
AU - Hayhoe, Benedict
AU - Costelloe, Céire
AU - Campbell, Anne
AU - Butler, Christopher C.
AU - Bright, Nicole
AU - Borek, Aleksandra J.
AU - Anyanwu, Philip E.
N1 - Publisher Copyright:
© The Author(s) 2024.
PY - 2024/12
Y1 - 2024/12
N2 - Bacteria are becoming increasingly resistant to antibiotics, reducing our ability to treat infections and threatening to undermine modern health care. Optimising antibiotic use is a key element in tackling the problem. Traditional economic evaluation methods do not capture many of the benefits from improved antibiotic use and the potential impact on resistance. Not capturing these benefits is a major obstacle to optimising antibiotic use, as it fails to incentivise the development and use of interventions to optimise the use of antibiotics and preserve their effectiveness (stewardship interventions). Estimates of the benefits of improving antibiotic use involve considerable uncertainty as they depend on the evolution of resistance and associated health outcomes and costs. Here we discuss how economic evaluation methods might be adapted, in the face of such uncertainties. We propose a threshold-based approach that estimates the minimum resistance-related costs that would need to be averted by an intervention to make it cost-effective. If it is probable that without the intervention costs will exceed the threshold then the intervention should be deemed cost-effective.
AB - Bacteria are becoming increasingly resistant to antibiotics, reducing our ability to treat infections and threatening to undermine modern health care. Optimising antibiotic use is a key element in tackling the problem. Traditional economic evaluation methods do not capture many of the benefits from improved antibiotic use and the potential impact on resistance. Not capturing these benefits is a major obstacle to optimising antibiotic use, as it fails to incentivise the development and use of interventions to optimise the use of antibiotics and preserve their effectiveness (stewardship interventions). Estimates of the benefits of improving antibiotic use involve considerable uncertainty as they depend on the evolution of resistance and associated health outcomes and costs. Here we discuss how economic evaluation methods might be adapted, in the face of such uncertainties. We propose a threshold-based approach that estimates the minimum resistance-related costs that would need to be averted by an intervention to make it cost-effective. If it is probable that without the intervention costs will exceed the threshold then the intervention should be deemed cost-effective.
UR - http://www.scopus.com/inward/record.url?scp=85205916680&partnerID=8YFLogxK
U2 - 10.1038/s43856-024-00516-9
DO - 10.1038/s43856-024-00516-9
M3 - Article
AN - SCOPUS:85205916680
SN - 2730-664X
VL - 4
JO - Communications Medicine
JF - Communications Medicine
IS - 1
M1 - 101
ER -