The economic burden of antimicrobial resistance (AMR) significantly exceeds the confines of the clinical world, with lasting repercussions for a society’s health and financial systems, as explained by Kevin Outterson, a professor at Boston University and founding executive director of CARB-X, in a recent interview with Infection Control Today®(ICT®). The conversation unveiled a critical discrepancy in the valuation of infection prevention efforts, where hospitals largely bear the immediate monetary brunt but the societal impact remains often unaccounted for.
When patients contract infections, hospitalization timelines expand and costs multiply, stretching healthcare facilities’ resources thin. Nevertheless, the economic devastation wrought by AMR extends past the healthcare boundaries, underscored by productivity losses, long-term disabilities, and viral spread among personal contacts. Secondary infections influencing families and communities amplify the toll of AMR, burdening economies and leaving hospitals to manage short-term budgetary adjustments.
To address this predicament plaguing the health and economic sectors alike, Outterson believes the infection prevention strategy ought to mirror that of a fire department; funded socially and oriented towards societal benefits. This argument for societal investment stems from the concept of positive externalities in economics where something of societal good, like infection prevention, is likely underinvested if the sole investor does not profit directly. He urges expanding this funding support beyond hospitals, to long-term care establishments and other healthcare settings. This could be potentially achieved by modifying Medicare remuneration policies to incentivize effective infection prevention.
Furthermore, Outterson highlights the broader implications of AMR, with potential threats to various industries including agriculture, trade, and food production. He cites the example of a recent antifungal for crops sharing its action mechanism with a soon-to-be-approved human drug, illustrating the ripple effects of sector-specific decisions on public health. However, he also emphasized successful initiatives such as the reduction of antibiotic use in Norway’s salmon industry following vaccine development for bacterial diseases in salmon.
Despite his leadership role in CARB-X, a major advocate for new antibiotics, vaccines, and diagnostics, Outterson acknowledges the prevailing funding deficit that hampers global innovation. He reaffirmed that the priorities of sepsis prevention, stewardship, and innovation are all integral, mutually complementary components of a viable strategy against bacterial evolution. He further identified a structural flaw in the US reimbursement scheme disincentivizing the adoption of new treatments and diagnostics that could potentially save lives, highlighting the need for accompanying legislative reform.
Outterson offered his backing to the PASTEUR Act, a bipartisan move meant to generate ‘subscription-style’ recompenses for hospitals that responsibly implement and utilize new antibiotics. A call to action prefaced his closing remarks, advocating the necessary restructuring of infection prevention funding to prioritize societal health needs over financial penalties. His conversation underscored the admirable contributions of infection prevention professionals, striving to make a difference in spite of the financial disincentives ingrained in the system.
Source: https://www.infectioncontroltoday.com/view/paying-prevention-how-fix-amr-s-broken-incentives