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Antimicrobial Resistance (AMR) Development Map: A Conceptual Map and a Tool to Support Economic Evaluation of AMR Interventions

Author

Listed:
  • Kristina Aluzaite

    (University of York)

  • Marta O. Soares

    (University of York)

  • Catherine Hewitt

    (University of York)

  • William Hope

    (The University of Liverpool)

  • Julie Robotham

    (UK Health Security Agency)

  • Beth Woods

    (University of York)

Abstract

Introduction Antimicrobial resistance (AMR) is a complex, inter-sectoral and international problem. Economic evaluation (EE) methods offer systematic, evidence-driven approaches to inform policy decisions about which AMR interventions to fund. EE of AMR interventions is complicated owing to diffuse effects, complex mechanics of the problem and high levels of uncertainty. Current AMR EE literature restricts the analytical scope, potentially resulting in omissions of effects that may limit the utility of EE to inform policy decisions. We aimed to systemise the key evolutionary and ecological processes of AMR to elucidate the paths through which AMR interventions impact population health and healthcare costs to support EE design and to support decision makers in understanding the limitations of EE evidence for decision-making. Methods A conceptual map and a corresponding tool were developed on the basis of a literature review in consultation with experts across the relevant disciplines of molecular biology, infectious disease modelling, health economics and ecology. Results The AMR development map: (1) distils the key AMR processes and process drivers behind AMR development and maps the available types of AMR interventions to AMR process drivers; (2) proposes a way to conceptualise the spatial scope of analysis through considering the connectivity of the wider ecosystem and (3) outlines the key dimensions that AMR burden and intervention effects could be measured across. An AMR development map tool was developed to support conceptual modelling, with the focus on the choice of scope in the EE of AMR interventions, and an illustrative case study was provided. Discussion This work summarises the key underlying biological principles of AMR development to provide mechanistical grounding for considering the scope of effects of AMR interventions and the appropriate system of analysis to support conceptual modelling in EE of AMR interventions. In addition, this map can facilitate the identification of effects that cannot be considered or quantified, thus enabling transparency about these omissions within decision-making.

Suggested Citation

  • Kristina Aluzaite & Marta O. Soares & Catherine Hewitt & William Hope & Julie Robotham & Beth Woods, 2025. "Antimicrobial Resistance (AMR) Development Map: A Conceptual Map and a Tool to Support Economic Evaluation of AMR Interventions," Applied Health Economics and Health Policy, Springer, vol. 23(5), pages 767-777, September.
    • Handle: RePEc:spr:aphecp:v:23:y:2025:i:5:d:10.1007_s40258-025-00969-6
    DOI: 10.1007/s40258-025-00969-6
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    References listed on IDEAS

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    1. Joanna Coast & Richard Smith & Anne‐Marie Karcher & Paula Wilton & Michael Millar, 2002. "Superbugs II: how should economic evaluation be conducted for interventions which aim to contain antimicrobial resistance?," Health Economics, John Wiley & Sons, Ltd., vol. 11(7), pages 637-647, October.
    2. Kristina Aluzaite & Marta O. Soares & Catherine Hewitt & Julie Robotham & Chris Painter & Beth Woods, 2025. "Economic Evaluation of Interventions to Reduce Antimicrobial Resistance: A Systematic Literature Review of Methods," PharmacoEconomics, Springer, vol. 43(6), pages 631-646, June.
    3. Drummond, Michael F. & Sculpher, Mark J. & Claxton, Karl & Stoddart, Greg L. & Torrance, George W., 2015. "Methods for the Economic Evaluation of Health Care Programmes," OUP Catalogue, Oxford University Press, edition 4, number 9780199665884.
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