Antimicrobial resistance : is health technology assessment part of the solution or part of the problem?

Colson, Abigail R. and Morton, Alec and Årdal, Christine and Chalkidou, Kalipso and Davies, Sally C. and Garrison, Louis P. and Jit, Mark and Laxminarayan, Ramanan and Megiddo, Itamar and Morel, Chantal M. and Nonvignon, Justice and Outterson, Kevin and Rex, John H. and Sarker, Abdur Razzaque and Sculpher, Mark and Woods, Beth and Xiao, Yue (2021) Antimicrobial resistance : is health technology assessment part of the solution or part of the problem? Value in Health, 24 (12). pp. 1828-1834. ISSN 1524-4733 (

[thumbnail of Colson-etal-VIH-2021-Antimicrobial-resistance-is-health-technology-assessment-part]
Text. Filename: Colson_etal_VIH_2021_Antimicrobial_resistance_is_health_technology_assessment_part.pdf
Final Published Version
License: Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 logo

Download (651kB)| Preview


Antimicrobial resistance is a serious challenge to the success and sustainability of our healthcare systems. There has been increasing policy attention given to antimicrobial resistance in the last few years, and increased amounts of funding have been channeled into funding for research and development of antimicrobial agents. Nevertheless, manufacturers doubt whether there will be a market for new antimicrobial technologies sufficient to enable them to recoup their investment. Health technology assessment (HTA) has a critical role in creating confidence that if valuable technologies can be developed they will be reimbursed at a level that captures their true value. We identify 3 deficiencies of current HTA processes for appraising antimicrobial agents: a methods-centric approach rather than problem-centric approach for dealing with new challenges, a lack of tools for thinking about changing patterns of infection, and the absence of an approach to epidemiological risks. We argue that, to play their role more effectively, HTA agencies need to broaden their methodological tool kit, design and communicate their analysis to a wider set of users, and incorporate long-term policy goals, such as containing resistance, as part of their evaluation criteria alongside immediate health gains.