The first symposium of the Annual Conference on Microbial Resistance focused on the economic and public policy aspects of antibiotic resistance and antibiotic development. 

Moderator Susan Foster, PhD, of the Alliance for the Prudent Use of Antibiotics (Boston, MA) presented first, then facilitated a Q&A session with other presenters Ramanan Laxminarayan, PhD, of Resources for the Future (Washington, DC) and Kevin Outterson, JD, LLM, of Boston University School of Law (Boston, MA).

Foster’s presentation focused on the Economic Consequences of Antibiotic Resistance.  She touched on the direct and indirect costs of drug resistance, including poorer patient health, burden to families, the need to find replacement drugs when current ones fail, and other topics. 

Foster used in-depth details of the Massachusetts Hospital Discharge Study done from 2000-2007 and the Chicago Cook County Hospital study to emphasize the importance of upgrading hospital information technology. 

Overall, Foster cited MRSA and VRE infections as accounting for 77 percent of resistant infections found in Chicago, while drug-resistant infections accounted for 5 percent of outpatient deaths between 2000-2007 in Boston. 

Based on aforementioned studies, Foster estimated that the national economic burden created by drug resistance is $16-26 billion per year.  She closed with a few words on the importance of safe and appropriate use of antibiotics as well as the importance of research and development of new, safer, more effective drugs.    

The second presentation on antibiotic development economics was given by Laxminarayan.  He correlated the severity of diseases to colonization with resistant pathogens which creates an estimated $378 million to $18.6 billion dollar increase in spending on antimicrobial-resistant drugs.

Laxminarayan urged the agricultural industry to cut antibiotics out of their animal feeding system as it is one of the biggest causes of antimicrobial resistance in humans.  He also emphasized the need for policy makers to offer incentives such as tax credits or priority vouchers for large pharmaceutical companies to innovate in research and development of new drugs.

“New antibiotics run the risk of strain resistance, thus reducing their profitable lifespan for the pharmaceutical industry,” said Laxminarayan.

The third presentation in the symposium was given by Outterson.  In “Assessing Incentives for Continued Antimicrobial Effectiveness,” Outterson suggested that the pharmaceutical industry strategize on how to conserve the reserve of existing drugs, based on the model followed by the petroleum industry.

“Approvals of new antibiotics by the FDA are declining, and expected to hit zero within the next decade,” said Outterson.  He also noted that of the 29 antibiotics approved by the FDA since the 1980s, only 9 remain on the market today.


Otterson offered concluding thoughts and suggestions on which infections the pharmaceutical industry should pursue in favor of public health, safety, and monetary reasons.  Suggested infections included acinetobacter baumannii, MRSA, VRE, and Aspergillus species.

Read more about the conference here.

Abstracts from the Economic Symposium or the rest of the conference are also available here (pdf).