Holmes Emily A F, Hughes Dyfrig A
Centre for Health Economics and Medicines Evaluation (CHEME), Bangor University, Normal Site, Bangor, Gwynedd LL57 2PZ, UK.
Antibiotics (Basel). 2019 Sep 27;8(4):166. doi: 10.3390/antibiotics8040166.
The threat of antimicrobial resistance has global health and economic consequences. Medical strategies to reduce unnecessary antibiotic prescribing, to conserve the effectiveness of current antimicrobials in the long term, inevitably result in short-term costs to health care providers. Economic evaluations of health care interventions therefore need to consider the short-term costs of interventions, to gain future benefits. This represents a challenge for health economists, not only in terms of the most appropriate methods for evaluation, but also in attributing the potential budget impact over time and considering health impacts on future populations. This commentary discusses the challenge of accurately capturing the cost-effectiveness of health care interventions aimed at tackling antimicrobial resistance. We reflect on methods to capture and incorporate the costs and health outcomes associated with antimicrobial resistance, the appropriateness of the quality-adjusted-life year (QALY), individual time preferences, and perspectives in economic evaluation.
抗菌药物耐药性的威胁对全球健康和经济都产生了影响。减少不必要的抗生素处方以长期维持现有抗菌药物有效性的医疗策略，不可避免地会给医疗服务提供者带来短期成本。因此，医疗保健干预措施的经济评估需要考虑干预措施的短期成本，以获取未来的收益。这对卫生经济学家来说是一项挑战，不仅体现在最恰当的评估方法上，还体现在确定随着时间推移潜在的预算影响以及考虑对未来人群的健康影响方面。本评论探讨了准确衡量旨在应对抗菌药物耐药性的医疗保健干预措施成本效益的挑战。我们思考了用于衡量和纳入与抗菌药物耐药性相关的成本及健康结果的方法、质量调整生命年（QALY）的适用性、个体时间偏好以及经济评估中的视角。
