ECONOMIC VALUES OF POLICY INTERVENTIONS TO REDUCE ANTIMICROBIAL RESISTANCE USE: A SCOPING REVIEW OF MODEL-BASED ECONOMIC EVALUATION STUDIES
Author(s)
Alyssa Grant, MSc, PhD1, Cacy Tran, BSc2, Candyce Hamel, PhD3, Brian Hutton, PhD2, Kednapa Thavorn, PhD2.
1Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa, ON, Canada, 2Ottawa Hospital Research Institute, Ottawa, ON, Canada, 3Canadian Association of Radiologists, Ottawa, ON, Canada.
1Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa, ON, Canada, 2Ottawa Hospital Research Institute, Ottawa, ON, Canada, 3Canadian Association of Radiologists, Ottawa, ON, Canada.
OBJECTIVES: Antimicrobial resistance (AMR) is a major global public health and economic challenge that threatens the effectiveness of antimicrobial therapies and increases morbidity, mortality, and healthcare costs. Mathematical modelling provides a valuable approach for evaluating the long-term health and economic impacts of government policies aimed at reducing antimicrobial use and mitigating AMR. However, evidence synthesizing the economic modelling literature on AMR policy interventions remains limited. This scoping review examined mathematical modelling studies evaluating the cost-effectiveness of government policy interventions targeting human antimicrobial use.
METHODS: A scoping review was conducted following Joanna Briggs Institute methodology and reported according to the PRISMA-ScR guideline. MEDLINE, Embase, Web of Science, and grey literature were searched for English-language studies published between 2010 and 2024. Eligible studies used mathematical models to evaluate the health and economic impacts of government-level AMR policy interventions. Data were extracted on study characteristics, intervention type, modelling approach, health outcomes, costs, and methodological quality.
RESULTS: From 6,120 unique records, 11 studies met the inclusion criteria. Studies evaluated antimicrobial stewardship, diagnostic testing, infection prevention and control, and novel antimicrobial introduction across hospital and national settings. Decision-analytic models were most common, followed by Markov and dynamic transmission models. Most interventions were cost-effective or cost-saving, particularly universal prevention strategies and evidence-based antimicrobial stewardship in high-risk settings. Cost-effectiveness was highly dependent on baseline resistance prevalence, transmission dynamics, intervention effectiveness, and implementation assumptions. Dynamic transmission models better captured long-term population benefits but required greater structural assumptions, whereas static models generally estimated short-term context-specific outcomes.
CONCLUSIONS: Economic evaluations consistently support the value of AMR policy interventions, although findings are highly context dependent. Model choice substantially influences estimated costs and outcomes, limiting comparability across studies. Future economic evaluations should improve reporting transparency, incorporate transmission dynamics and implementation factors, and strengthen uncertainty analyses to better inform AMR policy decision-making.
METHODS: A scoping review was conducted following Joanna Briggs Institute methodology and reported according to the PRISMA-ScR guideline. MEDLINE, Embase, Web of Science, and grey literature were searched for English-language studies published between 2010 and 2024. Eligible studies used mathematical models to evaluate the health and economic impacts of government-level AMR policy interventions. Data were extracted on study characteristics, intervention type, modelling approach, health outcomes, costs, and methodological quality.
RESULTS: From 6,120 unique records, 11 studies met the inclusion criteria. Studies evaluated antimicrobial stewardship, diagnostic testing, infection prevention and control, and novel antimicrobial introduction across hospital and national settings. Decision-analytic models were most common, followed by Markov and dynamic transmission models. Most interventions were cost-effective or cost-saving, particularly universal prevention strategies and evidence-based antimicrobial stewardship in high-risk settings. Cost-effectiveness was highly dependent on baseline resistance prevalence, transmission dynamics, intervention effectiveness, and implementation assumptions. Dynamic transmission models better captured long-term population benefits but required greater structural assumptions, whereas static models generally estimated short-term context-specific outcomes.
CONCLUSIONS: Economic evaluations consistently support the value of AMR policy interventions, although findings are highly context dependent. Model choice substantially influences estimated costs and outcomes, limiting comparability across studies. Future economic evaluations should improve reporting transparency, incorporate transmission dynamics and implementation factors, and strengthen uncertainty analyses to better inform AMR policy decision-making.
Conference/Value in Health Info
2026-11, ISPOR Europe 2026, Vienna, Austria
Value in Health, Volume 29, Issue 12S
Code
EE643
Topic
Economic Evaluation, Epidemiology & Public Health
Disease
Infectious Disease (non-vaccine)