ABSTRACT
Objectives: Traditional health economic evaluations of antimicrobials and other therapeutics such as vaccines currently underestimate their value to wider society. It can be supplemented by additional value elements including insurance value, which captures the value of a novel antimicrobial in preventing or mitigating impacts of adverse risk events such as those related to Covid-19 and antimicrobial resistance (AMR). Despite being commonplace in other sectors, constituents of the impacts and approaches for estimating insurance value of therapeutics have not been investigated. Method(s): This study assessed the insurance value of a novel antimicrobial, from the operational healthcare costs and several wider population health and societal perspectives. This was done by: (1) identifying risk events pertaining to 4 relevant scenarios: ward closures, unavoidable shortage of conventional antimicrobials, viral respiratory pandemics and catastrophic AMR, through literature review and multidisciplinary expert workshops, (2) parameterising constituent mitigable costs and frequencies of the risk events, and (3) applying a Monte Carlo simulation model for extreme events, and a dynamic disease transmission model. Modelling was implemented in Excel and R. Result(s): The mean insurance value across all scenarios and perspectives was 718m over a 10-year period, should AMR levels remain unchanged, where only 134m related to operational healthcare costs. The viral respiratory pandemics and catastrophic AMR scenarios contributed most to this value (290m and 297m respectively). This overall value would be 50-70% higher if AMR levels steadily increased or if a more risk-averse view (1-in-10 year downside) of future events is taken. Conclusion(s): The insurance value of a novel antimicrobial can be systematically modelled, and substantially augments their traditional health economic value in normal circumstances. These approaches are generalisable to any health intervention, and form a framework for health systems and governments to recognise broader value in health technology assessments and increase resilience by planning for adverse scenarios. Copyright © 2022
ABSTRACT
Community health is the health status, including physical and mental wellbeing, of a group of people within a defined geographic region. Factors like population size, economy, politics, social and culture play important roles on affecting the health of a community. Health care systems vary across the globe and there is a huge performance disparity between high-income and low-income countries and regions. Developed and wealthy countries in Americas and Europe like United States, Netherlands and United Kingdom have sufficient finance to support their health care systems, while many countries in the Asia-Pacific are once being identified as being in short of resources to support health care developments. In fact, regions like Australia, Singapore and Hong Kong have well-developed health care systems and China, too, has made great achievements in improving the health status of the population. Facing continuous threats to global health, ranging from growing of noncommunicable diseases, outbreaks of emergent infectious diseases, such as Ebola, to the latest pandemic of COVID-19, health care systems in all countries are facing the challenges in tackling these worldwide health issues. There is an urgent need to strengthen the equity of access to medical care and resources so that citizens are protected from diseases and can maintain a healthy living. © 2022 selection and editorial matter, Ben Y.F. Fong and Martin C.S. Wong;individual chapters, the contributors.