The Benefits That a Novel Antimicrobial Provides When Viewed From an Insurance Value Perspective

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

Whose health is it, anyway?

This book outlines why health, individually and collectively, is the greatest untapped opportunity for prosperity and happiness in the 21st century and introduces the concept of total health as a tool for valuing health. The most significant flaw in health systems today is a failure to value health but instead to count the costs of ill health, and the authors examine why this should be so from a range of perspectives. The costs of ill health are explored not only as an increasing portion of government spend, but also in relation to wider society, where entrenched inequalities result in the clustering of poor health, low educational attainment, and poor job prospects. The ways in which our health and the drivers of health have evolved are described, and their roles in preventing individuals from living well, learning, and working, are identified. The healthcare system is also examined, and revealed to be an illness service with little resilience, importing illness rather than exporting health, and failing to leverage the digital and technological innovations harnessed by other industries. The authors call for health to be valued, rather than ill health costed, and describe a 21st-century healthcare system that expands the NHS from an illness service to a true, total health service. COVID-19 has shown how vulnerable societies, economies, and daily lives are to ill health. This book demonstrates that, by valuing the pivotal role of health, societies could look to a happier and more prosperous future. © Oxford University Press 2021.