STEMMING THE SUPERBUG TIDEJUST A FEW DOLLARS MOREMichele CecchiniLead economist (Public Health)OECD

AMR Will Keep Increasing If No Effective Actions Are Put in Place

0

5

10

15

20

25

30

35

40

45

Prev

alen

ce r

ate

(%)

Resistance proportions for eight antibiotic-bacterium combinations in the OECD

2005 2015 2030

Source: OECD. Stemming the Superbug Tide: just a few dollars more. 2018. oe.cd/amr-2018

Resistance to 2nd and 3rd line Treatments Will Grow the Most

1st-line

2nd-line

3rd-line

75

100

125

150

175

200

225

250

2005 2010 2015 2020 2025 2030

Ant

imic

robi

al r

esis

tanc

e in

dex

[200

5 =

100

]am

ong

sele

cted

bug

-dru

g co

mbi

nati

ons

OECD countries

Source: OECD. Stemming the Superbug Tide: just a few dollars more. 2018. oe.cd/amr-2018

1st-line

2nd-line

3rd-line

75

100

125

150

175

200

225

250

2005 2010 2015 2020 2025 2030

EU28 countries

AMR Costs 3.5B USD PPPs per Year to the Healthcare Systems of 33 OECD and EU Countries

0

1

2

3

4

5

6

7

Ave

rage

yea

rly

cost

of A

MR

per

cap

ita

(USD

PPP

)

Source: OECD. Stemming the Superbug Tide: just a few dollars more. 2018. oe.cd/amr-2018

Only 9 OECD Countries Have Developed and Fund a ‘One-health’ AMR Action Plan

ARGAUSAUTBEL

BRABGR

CANCHL*

CHN

COLHRV

CYPCZE DNK

EST

FINFRADEU

GRCHUN

ISL

INDIDNIRL

ISR

ITA

JPN

LVALTU

LUX

MLTMEX

NLD

NZL

NOR

PER

POL*

PRT

KORROU

RUS

SAU

SVK

SVN

ZAFESP

SWE

CHE

TURGBRUSA

0

2

4

6

8

10

12

14

16

18

20

No national AMR action plan National AMR action plan underdevelopment

National AMR action plan developed National AMR action plan approved bygovernment that reflects Global Action

Plan objectives, with an operationalplan and monitoring arrangements

National AMR action plan has fundingsources identified, is being

implemented, involves relevant sectorsand has a defined monitoring and

evaluation process

Numb

er of

coun

tries

Source: OECD. Stemming the Superbug Tide: just a few dollars more. 2018. oe.cd/amr-2018

Healthcare settings Community setting

Policy Approaches to Tackle Irrational Use of Antimicrobials

Stewardship programmesto promote prudent use of antibiotics and end decadesof over-prescription

Enhanced hygieneto minimize cross-patient transmission of infections through medical devices

Mass media campaignsto make people aware of the risks associated with imprudent use of antibiotics

Rapid diagnostic teststo detect whether an infection requires antibiotics or not, in primary care settings

Improved hand hygieneto promote and facilitate hand-washing in healthcare professionals

Delayed prescriptionsto decrease consumption of antibiotics for viral infections

‘Mixed-package’

Source: OECD. Stemming the Superbug Tide: just a few dollars more. 2018. oe.cd/amr-2018

All the Assessed Interventions Can Be Considered ‘Best Buys’ to Tackle AMR in OECD and EU

0%

20%

40%

60%

80%

100%

Improved handhygiene

Delayedprescription

Stewardshipprogram

Rapid diagnostictests

Enhancedenvironmental

hygiene

Mass mediacampaigns

Ave

rage

pro

babi

lity

acr

oss

coun

trie

s

Cost-saving CE ratio<50 000 USD PPP/DALY CE ratio>50 000 USD PPP/DALY Inferior to business as usual

Source: OECD. Stemming the Superbug Tide: just a few dollars more. 2018. oe.cd/amr-2018

The Mixed-Package Would Save up to 47,000 Lives per Year in OECD and EU…

Source: OECD. Stemming the Superbug Tide: just a few dollars more. 2018. oe.cd/amr-2018

… And Save 4.8B* USD/year to the Budget of Healthcare Systems

-15

-12

-9

-6

-3

0

3

6

USD

per

cap

ita

per

year

Economic assessment of the ‘mixed-intervention’ package:just a few dollars more produce substantial savings in healthcare expenditure

Implementation cost Impact on healthcare expenditure

Source: OECD. Stemming the Superbug Tide: just a few dollars more. 2018. oe.cd/amr-2018

Note: * Including effect on susceptible infections

Stemming the Superbug TideJust a Few Dollars More

michele.cecchini@oecd.org More info at: oe.cd/amr-2018

• AMR will keep increasing, globally

• The projected rise in resistance to 2nd and 3rd line antibiotics is particularly worrisome

• Interventions to increase hygiene show the most positive effects but do not address some of the key determinants of AMR

• Public health interventions to tackle AMR are a cost-effective (and very often cost-saving) investment in OECD and EU countries

• Combining interventions in a comprehensive public health package provides best results