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. ISSN 1524-4733 (In Press)

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    Antimicrobial resistance (AMR) is a serious challenge to the success and sustainability of our healthcare systems. There has been increasing policy attention given to AMR in the last few years, and increased amounts of funding have been channelled into funding for research and development (R&D) of antimicrobials. However, 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 which captures their true value. We identify three deficiencies of current HTA processes for appraising antimicrobials: a methods- 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, in order to play their role more effectively, HTA agencies need to broaden their methodological toolkit, 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.

    ORCID iDs

    Colson, Abigail R. ORCID logoORCID:, Morton, Alec ORCID logoORCID:, Årdal, Christine, Chalkidou, Kalipso, Davies, Sally C., Garrison, Louis P., Jit, Mark, Laxminarayan, Ramanan, Megiddo, Itamar ORCID logoORCID:, Morel, Chantal M., Nonvignon, Justice, Outterson, Kevin, Rex, John H., Sarker, Abdur Razzaque, Sculpher, Mark, Woods, Beth and Xiao, Yue;