This paper systematically reviews existing evidence from AMR-related economic evaluation studies, revealing common methodological deficiencies and providing important references for future study designs.
Literature Overview
This article, titled 'Existing Evidence from Economic Evaluations of Antimicrobial Resistance—A Systematic Literature Review' and published in the journal Antibiotics, reviews and summarizes the existing evidence from economic evaluation studies on antimicrobial resistance (AMR). It analyzes methodological flaws and evidence gaps in the studies, particularly the lack of research in low- and middle-income countries (LMICs) and the regions of Africa, Southeast Asia, and the Eastern Mediterranean.
Background Knowledge
Antimicrobial resistance (AMR) has become a significant global public health challenge, with profound impacts on the health of humans, animals, and the environment. The economic burden of AMR is substantial; according to predictions by the World Bank, AMR could result in annual GDP losses of up to 3.4 trillion USD by 2030 and increase global healthcare costs by an additional 1 trillion USD by 2050. Despite numerous existing studies, most economic evaluation studies exhibit significant methodological shortcomings, such as inadequate data representation, errors in cost estimation, and limited generalizability. In countries with limited resources, the reliability of AMR economic evaluations is further hampered by data scarcity, simplistic study designs, and insufficient sample sizes. By systematically analyzing 93 studies, this paper identifies the major limiting factors in AMR economic evaluations and offers insights for improving study design and policy formulation.
Research Methods and Experiments
The researchers conducted a systematic literature review following the PRISMA guidelines, searching PubMed and the Cochrane Database for all empirical studies on AMR economic evaluations published up to July 2023. Through independent dual-blind screening and data extraction, 93 studies were ultimately included. The studies were categorized based on the type of economic evaluation (e.g., cost-effectiveness analysis, cost of illness, cost-benefit analysis) and their quality was assessed. The study also specifically examined nine common methodological flaws in AMR economic evaluations, including overestimation or underestimation of outcomes, lack of primary data, cost estimation errors, and limited generalizability.
Key Conclusions and Perspectives
Research Significance and Prospects
This study highlights systemic flaws in AMR economic evaluations, particularly the severe lack of evidence in LMICs. Future studies should emphasize multi-center, community-oriented, and One Health approaches, improve data collection and cost estimation methods, and enhance generalizability and policy relevance. Additionally, more standardized research frameworks should be developed to ensure findings accurately reflect real-world scenarios, providing a stronger economic basis for global AMR control policies.
Conclusion
This paper summarizes the current state of economic evaluation studies on AMR, pointing out significant geographical and methodological biases in the existing evidence. Most studies originate from high-income countries and focus on hospital settings, with insufficient attention to community-based or One Health perspectives. Common issues in these studies include inadequate sample representation, cost estimation errors, limited generalizability, and the omission of key variables. More studies from low- and middle-income countries are needed, using multi-center and prospective designs and incorporating more comprehensive economic indicators to more accurately assess the global economic impact of AMR and inform policy development.
