A one health framework to estimate the cost of antimicrobial resistance

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dc.contributor.authorMorel, Chantal M
dc.contributor.authorAlm, Richard A
dc.contributor.authorÅrdal, Christine
dc.contributor.authorBandera, Alessandra
dc.contributor.authorBruno, Giacomo M
dc.contributor.authorCarrara, Elena
dc.contributor.authorColombo, Giorgio L
dc.contributor.authorde Kraker, Marlieke E A
dc.contributor.authorEssack, Sabiha
dc.contributor.authorFrost, Isabel
dc.contributor.authorGonzalez-Zorn, Bruno
dc.contributor.authorGoossens, Herman
dc.contributor.authorGuardabassi, Luca
dc.contributor.authorHarbarth, Stephan
dc.contributor.authorJørgensen, Peter S
dc.contributor.authorKanj, Souha S
dc.contributor.authorKostyanev, Tomislav
dc.contributor.authorLaxminarayan, Ramanan
dc.contributor.authorLeonard, Finola
dc.contributor.authorHara, Gabriel L
dc.contributor.authorMendelson, Marc
dc.contributor.authorMikulska, Malgorzata
dc.contributor.authorMutters, Nico T
dc.contributor.authorOutterson, Kevin
dc.contributor.authorBaňo, Jesus R
dc.contributor.authorTacconelli, Evelina
dc.contributor.authorScudeller, Luigia
dc.date.accessioned2021-06-29T19:56:15Z
dc.date.available2021-06-29T19:56:15Z
dc.date.issued2020-11-26
dc.date.updated2020-11-29T04:20:02Z
dc.description.abstractAbstract 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.
dc.identifier.ris TY - 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 L AU - Mendelson, Marc AU - Mikulska, Malgorzata AU - Mutters, Nico T AU - Outterson, Kevin AU - Baňo, Jesus R AU - Tacconelli, Evelina AU - Scudeller, Luigia AB - Abstract 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. DA - 2020-11-26 DB - OpenUCT DP - University of Cape Town IS - 1 J1 - Antimicrobial Resistance & Infection Control KW - Antimicrobial resistance KW - Cost KW - One health LK - https://open.uct.ac.za PY - 2020 T1 - A one health framework to estimate the cost of antimicrobial resistance TI - A one health framework to estimate the cost of antimicrobial resistance UR - http://hdl.handle.net/11427/33419 ER - en_ZA
dc.identifier.urihttps://doi.org/10.1186/s13756-020-00822-6
dc.identifier.urihttp://hdl.handle.net/11427/33419
dc.language.rfc3066en
dc.rights.holderThe Author(s)
dc.sourceAntimicrobial Resistance & Infection Control
dc.source.journalissue1
dc.source.journalvolume9
dc.source.pagination187
dc.source.urihttps://aricjournal.biomedcentral.com/
dc.subjectAntimicrobial resistance
dc.subjectCost
dc.subjectOne health
dc.titleA one health framework to estimate the cost of antimicrobial resistance
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