A macroeconomic approach to evaluating policies to contain antimicrobial resistance: a case study of methicillin-resistant Staphylococcus aureus (MRSA).

BACKGROUND: Antimicrobial resistance (AMR) is, at least in part, associated with high antimicrobial usage and causes increased morbidity, mortality and healthcare costs. However, policies to contain AMR focus on 'micro' interventions - typically in one institution (usually a hospital). Furthermore, in evaluating these interventions, economists tend to concentrate on the economic impact to the healthcare sector alone, which may give an incorrect estimation of the social costs and benefits of a disease or intervention. METHODS: This study outlines and illustrates a macroeconomic approach to tackling AMR through the evaluation of three 'macro' policies: regulation, permits and taxes/charges. In addition to effects on the healthcare sector, the effect of AMR (and these three policies to contain it) on labour productivity, GDP, household income, government transfers, tax revenues, unemployment, inflation and social services are estimated for the UK using the specific context of methicillin-resistant Staphylococcus aureus (MRSA). RESULTS: AMR is likely to have a far greater impact on the national economy than would be estimated by concentrating on the healthcare sector alone. CONCLUSION: The permit system appears to offer the most efficient 'solution' to optimising antimicrobial consumption and, hence, reducing the development of resistance.