OBJECTIVES: In the past century, antibiotics have led to a gain in life expectancy of approximately 20 years. However, over time, antimicrobial resistance (AMR) is accelerating, becoming a global public health concern with serious health and financial consequences: if nothing is done, estimates suggest AMR could cause 10 million deaths and cost $100 trillion annually by 2050. Therefore, understanding societal preference for the use of antibiotics, as well as eliciting the willingness to pay (WTP) for future antimicrobial drug development, is crucial. The objective of this study was to investigate individuals’ preferences for different strategies to contain AMR employing discrete choice experiments (DCE).

METHODS: A DCE was administered to a sample of the UK adult population. Respondents were asked to make 9 choices between 2 hypothetical “doctor and antibiotics” scenarios and 1 “no doctor – no antibiotics” option defined by five attributes: treatment, days needed to recover, risk of bacterial infection which needs antibiotics, risk of common side effects and risk of AMR by 2050. Data were analyzed using random-parameters logit models.

RESULTS: 2,436 respondents completed the survey. The risk of AMR by 2050 was the most important attribute being 3.8 (0.74÷0.195) times as important as days needed to recover; although, when presented with a higher risk of bacterial infection, respondents placed a lower importance on the risk of AMR by 2050. In a follow up contingent valuation question to estimate the monetary value of AMR policies, we also found an average WTP of ~£60 annually for 5 years per household.

CONCLUSIONS: The risk of AMR is relevant and important. The aggregate WTP for containing AMR is about £5.7 billion, and with society’s preferences for the attributes of future approaches to combat AMR, should help policy makers develop future AMR strategies.