A General Public Study on Preferences and Welfare Impacts of Antimicrobial Resistance in the United Kingdom

Abstract

Background: Antibiotics have led to considerable increases in life expectancy. However, over time, antimicrobial resistance (AMR) has accelerated and is now a significant global public health concern. Understanding societal preferences for the use of antibiotics as well as eliciting the willingness to pay (WTP) for future research is crucial. Objective: To investigate preferences for different strategies to optimize antibiotic use and to understand WTP for future research in AMR and antimicrobial drug development. Methods: A discrete-choice experiment (DCE) was administered to a sample of the United Kingdom general population. Respondents were asked to make nine choices, each offering three options—two hypothetical “doctor and antibiotics” and one “no doctor – no antibiotics”—defined by five attributes: treatment, days needed to recover, risk of bacterial infection that needs antibiotics, risk of common side effects, and risk of AMR by 2050. Data were analyzed using random parameters logit models. A double bounded contingent valuation was also included in the survey to explore WTP for policies to contain AMR. Results: Among the 2,579 respondents who completed the survey, 1,151 always selected “no doctor– no antibiotic” and 57 never varied their choices; therefore, 1,371 responses were used in the analysis. Risk of AMR by 2050 was the most important and the “treatment” was the least important attribute, although this was sensitive to a higher risk of bacterial infection. The aggregate annual WTP for containing AMR was approximately £8.35 billion (~£5-£10 billion). Conclusions: The AMR risk is relevant and important to the general public. The high WTP suggests that large investments in policies or interventions to combat AMR are justified