From: Using the best available data to estimate the cost of antimicrobial resistance: a systematic review
Author (year) Country | Organism Comparators Site of infection | Methodology | Excess LOS (days) | Cost drivers | Type of costs (year of cost data) Currency Excess cost, significance |
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Taylor (2010) Global 2010 [21] | S. aureus, E. coli, K. pneumoniae, HIV, malaria, TB MRSA 3GC-E.coli 3GC-K. pneumoniae Resistant HIV Resistant malaria MDR-TB BSI, UTI, Lower RTI, SSTI | Theoretical dynamic general equilibrium was used to predict future scenarios of incidence and resistance (0%, current rates, 5, 40, 100% resistance) starting with the population in 2010 and projecting to 2050. Costs: (a) increased mortality (b) increased morbidity due to prolonged period of sickness leading to productivity loss Assumptions: (i) Resistance rates increase in a one-off step, not an S-shaped epidemic pattern (ii) Incidence remains constant until 2050 (except malaria where it was projected) (iii) Extra LOS was assumed to be the same for all countries/regions (iv) Mortality risk per infection remained unchanged | Mean excess LOS from the WHO Observatory (2014) | Loss of productivity | Disruption to the supply of labour by increased mortality and morbidity measured as reduction in GDP (2011) US Current cost: US$5.8 trillion Excess cost (over 40 yrs): Loss of US$2.1- $124.5 trillion |
KPMG (2014) 156 countries Data sourced from various publication with the latest from year 2012 [22] | S. aureus, E. coli, K. pneumoniae, HIV, malaria, TB Susceptible versus Resistant BSI Lower RTI SSTI UTI | Total factor productivity model used to compute macroeconomic stability, technology, quality of infrastructure, human capital and strength of public institutions. Life expectancy used as a proxy to measure the quality of human capital and adjustments to country life expectancy score were made to allow for deterioration of human capital as result of increased AMR incidence. Labour force was based on working age (15–64) and adjusted to AMR mortality rate Costs: (a) attributable mortality (b) increased morbidity leading to productivity loss. Assumptions: (i) Correction coefficient used to estimate resistance rate by site of infection was assumed to be the same for all countries/ regions (ii) Extra LOS analysed for EU, Iceland and Norway only (iii) Mortality risk per infection remained unchanged | Combined (S. aureus + E. coli + K. pneumonia): 4 mil bed-days in 2012 | Loss of productivity + cost of hospital bed-days | Impact on labour force and human capital measured as reduction in GDP (2012) EURO Excess cost: +€1.6 billion Global GDP loss (2050): 40% resistant: 1.66% 100% resistant: 3.4% |