A macroeconomic approach to evaluating policies to contain antimicrobial resistance

A case study of methicillin-resistant Staphylococcus aureus (MRSA)
  • Richard D. SmithEmail author
  • Milton Yago
  • Michael Millar
  • Joanna Coast
Original Research Article



Antimicrobial resistance (AMR) is, at least in part, associated with high antimicrobial usage and causes increased morbidity, mortality and healthcare costs. However, policies to contain AMR focus on ‘micro’ interventions — typically in one institution (usually a hospital). Furthermore, in evaluating these interventions, economists tend to concentrate on the economic impact to the healthcare sector alone, which may give an incorrect estimation of the social costs and benefits of a disease or intervention.


This study outlines and illustrates a macroeconomic approach to tackling AMR through the evaluation of three ‘macro’ policies: regulation, permits and taxes/charges. In addition to effects on the healthcare sector, the effect of AMR (and these three policies to contain it) on labour productivity, GDP, household income, government transfers, tax revenues, unemployment, inflation and social services are estimated for the UK using the specific context of methicillin-resistant Staphylococcus aureus (MRSA).


AMR is likely to have a far greater impact on the national economy than would be estimated by concentrating on the healthcare sector alone.


The permit system appears to offer the most efficient ‘solution’ to optimising antimicrobial consumption and, hence, reducing the development of resistance.


Labour Supply Policy Option Computable General Equilibrium Healthcare Sector Intermediate Input 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.



The authors would like to express their appreciation to Anne Mills and Paul Coleman of the LSHTM, Alistair Munro of the University of East Anglia and Tim Peters of the University of Bristol for their advice and comments as members of the Project Advisory Group. Thanks are also due to John Wyn-Owen and The Nuffield Trust for hosting project management and Advisory Group meetings, as well as providing financial support for this work. Useful comments were also received from participants at the Fourth Congress of the International Health Economics Association in San Francisco, the International Society for Technology Assessment in Health Care meeting in Canada, and two anonymous referees. Thanks also to Ali Bayar and Masudi Opese of Ecomod Network and Universite Libre de Bruxelles, for their willingness to answer many of our technical questions. However, the analysis and results of the paper remain the authors’ responsibility. There are no conflicts of interest represented by any of the authors.


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Copyright information

© Adis Data Information BV 2006

Authors and Affiliations

  • Richard D. Smith
    • 1
    Email author
  • Milton Yago
    • 1
  • Michael Millar
    • 2
  • Joanna Coast
    • 3
  1. 1.School of Medicine, Health Economics Group, Health Policy & PracticeUniversity of East AngliaNorwichUK
  2. 2.Department of Medical Microbiology, Barts & The London NHS TrustRoyal London HospitalWhitechapelUK
  3. 3.Department of Social MedicineUniversity of BristolBristolUK

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