Aluzaite, Kristina, Soares, Marta O orcid.org/0000-0003-1579-8513, Hewitt, Catherine Elizabeth orcid.org/0000-0002-0415-3536 et al. (3 more authors) (2025) Antimicrobial Resistance (AMR) Development Map:A Conceptual Map and a Tool to Support Economic Evaluation of AMR Interventions. Applied Health Economics and Health Policy. ISSN 1175-5652
Abstract
INTRODUCTION: Antimicrobial resistance (AMR) is a complex, inter-sectoral and international problem. Economic evaluation (EE) methods offer systematic, evidence-driven approaches to inform policy decisions about which AMR interventions to fund. EE of AMR interventions is complicated owing to diffuse effects, complex mechanics of the problem and high levels of uncertainty. Current AMR EE literature restricts the analytical scope, potentially resulting in omissions of effects that may limit the utility of EE to inform policy decisions. We aimed to systemise the key evolutionary and ecological processes of AMR to elucidate the paths through which AMR interventions impact population health and healthcare costs to support EE design and to support decision makers in understanding the limitations of EE evidence for decision-making. METHODS: A conceptual map and a corresponding tool were developed on the basis of a literature review in consultation with experts across the relevant disciplines of molecular biology, infectious disease modelling, health economics and ecology. RESULTS: The AMR development map: (1) distils the key AMR processes and process drivers behind AMR development and maps the available types of AMR interventions to AMR process drivers; (2) proposes a way to conceptualise the spatial scope of analysis through considering the connectivity of the wider ecosystem and (3) outlines the key dimensions that AMR burden and intervention effects could be measured across. An AMR development map tool was developed to support conceptual modelling, with the focus on the choice of scope in the EE of AMR interventions, and an illustrative case study was provided. DISCUSSION: This work summarises the key underlying biological principles of AMR development to provide mechanistical grounding for considering the scope of effects of AMR interventions and the appropriate system of analysis to support conceptual modelling in EE of AMR interventions. In addition, this map can facilitate the identification of effects that cannot be considered or quantified, thus enabling transparency about these omissions within decision-making.
Metadata
Item Type: | Article |
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Authors/Creators: |
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Copyright, Publisher and Additional Information: | This is an author-produced version of the published paper. Uploaded in accordance with the University’s Research Publications and Open Access policy. |
Dates: |
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Institution: | The University of York |
Academic Units: | The University of York > Faculty of Social Sciences (York) > Centre for Health Economics (York) The University of York > Faculty of Sciences (York) > Health Sciences (York) |
Depositing User: | Pure (York) |
Date Deposited: | 17 Apr 2025 14:50 |
Last Modified: | 21 May 2025 14:00 |
Published Version: | https://doi.org/10.1007/s40258-025-00969-6 |
Status: | Published online |
Refereed: | Yes |
Identification Number: | 10.1007/s40258-025-00969-6 |
Open Archives Initiative ID (OAI ID): | oai:eprints.whiterose.ac.uk:225625 |
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