The costs attributable to antimicrobial resistance (AMR) remain theoretical and largely unspecified. Current figures fail to capture the full health and economic burden caused by AMR across human, animal, and environmental health; historically many studies have considered only direct costs associated with human infection from a hospital perspective, primarily from high-income countries. The Global Antimicrobial Resistance Platform for ONE-Burden Estimates (GAP-ON€) network has developed a framework to help guide AMR costing exercises in any part of the world as a first step towards more comprehensive analyses for comparing AMR interventions at the local level as well as more harmonized analyses for quantifying the full economic burden attributable to AMR at the global level. GAP-ON€ (funded under the JPIAMR 8th call (Virtual Research Institute) is composed of 19 international networks and institutions active in the field of AMR. For this project, the Network operated by means of Delphi rounds, teleconferences and face-to-face meetings. The resulting costing framework takes a bottom-up approach to incorporate all relevant costs imposed by an AMR bacterial microbe in a patient, in an animal, or in the environment up through to the societal level. The framework itemizes the epidemiological data as well as the direct and indirect cost components needed to build a realistic cost picture for AMR. While the framework lists a large number of relevant pathogens for which this framework could be used to explore the costs, the framework is sufficiently generic to facilitate the costing of other resistant pathogens, including those of other aetiologies. In order to conduct cost-effectiveness analyses to choose amongst different AMR-related interventions at local level, the costing of AMR should be done according to local epidemiological priorities and local health service norms. Yet the use of a common framework across settings allows for the results of such studies to contribute to cumulative estimates that can serve as the basis of broader policy decisions at the international level such as how to steer R&D funding and how to prioritize AMR amongst other issues. Indeed, it is only by building a realistic cost picture that we can make informed decisions on how best to tackle major health threats.

中文翻译：

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估算抗菌素耐药性成本的单一健康框架

抗菌素耐药性 (AMR) 造成的成本仍然是理论上的，而且很大程度上没有具体说明。目前的数据未能反映抗菌素耐药性对人类、动物和环境健康造成的全部健康和经济负担；历史上许多研究仅从医院角度考虑与人类感染相关的直接成本，主要来自高收入国家。全球抗菌素耐药性单一负担估算平台 (GAP-ON€) 网络开发了一个框架，帮助指导世界任何地区的抗菌药物耐药性成本计算工作，这是迈向更全面分析的第一步，以比较地方一级的抗菌素耐药性干预措施和抗菌药物耐药性干预措施。以及更统一的分析，以量化全球层面抗微生物药物耐药性造成的全部经济负担。GAP-ON€（由 JPIAMR 第 8 次呼吁（虚拟研究所）资助，由活跃于 AMR 领域的 19 个国际网络和机构组成。对于该项目，该网络通过德尔菲轮次、电话会议和面对面的方式运作由此产生的成本计算框架采用自下而上的方法，将 AMR 细菌微生物在患者、动物或环境中直至社会层面造成的所有相关成本纳入其中。该框架将流行病学数据逐项列出：以及建立抗微生物药物耐药性实际成本图所需的直接和间接成本组成部分。虽然该框架列出了可使用该框架来探索成本的大量相关病原体，但该框架具有足够的通用性，有助于计算以下病原体的成本：为了进行成本效益分析以在地方一级选择不同的 AMR 相关干预措施，AMR 的成本应根据当地流行病学重点和当地卫生服务规范进行。然而，跨环境使用共同框架可以使此类研究的结果有助于累积估计，这些估计可以作为国际层面更广泛政策决策的基础，例如如何引导研发资金以及如何在其他问题中优先考虑抗菌素耐药性。事实上，只有通过建立现实的成本情况，我们才能就如何最好地应对重大健康威胁做出明智的决定。