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Taxing certain antibiotics could reduce dependance and help tackle threat of drug resistance

Tax on antibiotics could help tackle threat of drug-resistance
Tax on antibiotics could help tackle threat of drug-resistance Copyright Canva
Copyright Canva
By Oceane Duboust
Published on Updated
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Antimicrobial resistance (AMR) is a major public health concern, and a new study looks into how taxation could impact antibiotic prescriptions.

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Taxing broad-spectrum antibiotics that contribute most to drug resistance could reduce prescriptions in favour of other medicines, UK-based researchers say.

The main contributor to antimicrobial resistance (AMR), which is when bacteria no longer respond to medicine, is overuse and misuse of antibiotics. 

Antibiotics are categorised as narrow-spectrum (i.e. targeting specific bacteria) or broad-spectrum (those used more broadly).

While narrow-spectrum drugs can help slow AMR, they require knowledge of the bacteria causing an infection, whereas broad-spectrum antibiotics don't.

Researchers looked at the impact of imposing a "tax" on general practitioners (GPs) when they prescribe broad-spectrum antibiotics, basing their research on 10 years of monthly UK antibiotic sales data analysis.

They published their findings in the International Journal of Industrial Organisation.

"Antibiotic resistance is an important issue and a priority for UK health policy. It’s possibly the next ticking time bomb in the healthcare system," Farasat Bokhari, a professor from Loughborough University and one of the study's co-authors, said in a statement. 

"In our analysis, the financial burden of the tax is not on the patients but rather on the GP practices who may be overprescribing in some cases," he added.

Shifting to narrow-spectrum antibiotics

The idea is to create a financial incentive for shifting from broad-spectrum antibiotics to narrow-spectrum antibiotics.

They looked at several different tax possibilities. One such option was a 20 per cent tax on all antibiotics or one applied only to the broad-spectrum antibiotics that contribute most to AMR: co-amoxiclav, quinolones, and cephalosporins.

A tax on these broad-spectrum drugs resulted in a 37.7 per cent drop in their use and a decrease of 2.38 per cent in overall antibiotic use.

A more generalised tax on all antibiotics reduced the use of the most problematic broad-spectrum antibiotics by 29.4 per cent and the overall use of antibiotics by 12.7 per cent. It resulted in a higher consumer welfare loss, the researchers said.

"Our findings show that switching from broad to narrow-spectrum is possible via changes in relative prices brought about via taxation, but it has implications - in terms of the total cost to society," Bokhari said.

"While the alternative tax regimes we consider differ in how much demand will shift, our estimates suggest that these policies can be highly effective in managing that demand," he added.

The researchers said that tax policies should include exemptions based on disease severity and recognised that in urgent situations where waiting for precise diagnostic tests isn’t feasible, the transition to narrow-spectrum antibiotics may be delayed.

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Taxation could be as effective as a ban

Dominic Moran, a professor of agricultural and resource economics at the University of Edinburgh, has studied the impact of taxing antimicrobial drugs for livestock animals, finding that it could be as effective as a ban.

Moran, who was not involved in the recent study, said in an e-mail that there is "growing awareness of how AMR might be treated in the same way as other pollution problems and the idea of a tax on the use of antimicrobials is one policy approach to managing the careful stewardship of more valuable antimicrobial compounds".

"This study raises some interesting issues around the likely tax levels and who should pay the tax. Ultimately, policy on AMR will have to consider all possible ways to manage demand and use of these drugs," Moran added.

AMR causes more than 670,000 infections each year and approximately 33,000 deaths in the European Union, according to some estimates.

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In 2019, the World Health Organization (WHO) recognised AMR as one of the top 10 global public health threats facing humanity.

"The consumer welfare loss and overall welfare loss from taxing these antibiotics are significant, however, they are relatively small compared to the predicted societal costs of antibiotic resistance in terms of deaths and economic losses," said lead author Dr Weijie Yan from consulting firm E.CA Economics.

"While our simulations show how much demand is shifted from broad to narrow-spectrum, and at what cost, it does not calculate the long-term benefits of switching to drugs with a lower AMR footprint," he added.

Additional sources • Contributing reporting by Lauren Chadwick

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