The Economics of Resistance Through an Ethical Lens

Abstract

Economics is concerned with the analysis of choice and the efficient use of resources. Markets for antibiotics are heavily affected by their ‘public good’ nature and the externality that results from their consumption in terms of resistance. The non-excludability and non-rivalry associated with knowledge production in antibiotic development also has implications for the supply of antibiotics. On the demand side there are ethical issues associated with free-riding by consumers, free-riding across nations and free-riding across time. On the supply side, the lack of a pipeline for new antibiotics for the future causes both ethical and economic issues – and from both perspectives, efforts should perhaps focus more on alternatives to antibiotics and adjustments to heath care systems to reduce reliance on antibiotics. Indeed, unlike many areas of health care, where economics and ethical perspectives may differ, antimicrobial resistance is a case where the two perspectives align in terms of ensuring efficient and sustainable development and use of this precious resources. All strategies for dealing with resistance should share the same goals of achieving an optimal balance in the use of antimicrobial agents and explicit consideration of the distributional implications.

Why We Should Reexamine the “Golden Age” of Antibiotics in Social Context

“…21 Economics does provide one way to understand the market failures that contribute to a paucity of innovation and can be consonant with ethical perspectives. 22 Antibiotic resistance is a prime example of an externality that contributes to market failure: a cost borne by society as a whole as infections become more difficult to treat. Industrialized agriculture pollution of waterways that results in antibiotic resistance is another form of externality.…”