The Problem
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New Study: Hospitalizations Related to Superbug Infections Double Over Six Years
Antibiotic Resistance Reaches Epidemic Proportions; Researchers Say Infection Control Should Be “National Priority”
Washington, November 29, 2007 – Hospital admissions related to methicillin-resistant Staphylococcus aureus (MRSA) infections more than doubled, from 127,000 to nearly 280,000, between 1999 and 2005, according to a new study in the December issue of the journal Emerging Infectious Diseases. During that same period, hospitalizations of patients with general staph infections increased 62 percent across the country.
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Incentives Essential to Ease Antibiotic Resistance Crisis
Concerns mount over failing antibiotics; economists and scientists collaborate on comprehensive incentives to ensure future supply of disease-fighting drugs that work
Washington, March 22, 2007 — A new report by prominent economists and scientists identifies market and regulatory incentives as crucial to combat a growing public health crisis – the escalating resistance of many infection-causing bacteria to traditional antibiotic treatments.
Extending the Cure: Policy Responses to the Growing Threat of Antibiotic Resistance is the first-ever comprehensive study to explore the pros and cons of incentive-based policies designed to protect the effectiveness of antibiotics, a valuable shared resource across the globe.
"Superbug" Blog
On April 3, Maryn McKenna cites Ramanan Laxminarayan as he outlines emerging antibiotic resistance as a problem of misaligned incentives and a challenge in resource management.
Superbug Post (April 3, 2008)
Chicago Tribune Letter-to-the-Editor
On March 21, the Chicago Tribune published the following letter-to-the-editor by ETC Principal Investigator Anup Malani:
“The March 18 article, "Study backs anti-infection tests of all hospital patients," (Metro) highlights an important question in the fight against the spread of deadly antibiotic-resistant superbugs and hospital-acquired infections in our nation's hospitals: is a comprehensive patient -screening program for methicillin-resistant Staphylococcus aureus (MRSA) the right strategy?
Improving hospital surveillance, reporting infections to public health departments, and infection control can help manage the emergence of antibiotic-resistant infections. The important question is which approach is best when hospitals have limited resources? Screening each patient that walks through the door is costly, and additional financial analysis is needed to determine if the benefits are greater than the costs. There may be other, more effective life-saving investments hospitals and public health departments should make. Encouraging hospitals to share information on infections, investing in better infection control in hospitals or regulating use of antibiotics by doctors are alternative strategies.
Even if comprehensive screening is cost effective, that may not be enough to get hospital to conduct such screening. If health care payers reimburse hospitals for treating MRSA infections rather than preventing them, hospitals may not find it in their financial interest to screen. The Centers for Medicare and Medicaid realize this and have reduced reimbursements for certain MRSA infections hospitals should be able to avoid. But these reforms are limited: they only apply to MRSA infections from catheters. More widespread reform of payment policy and incentives may be required to make sure hospitals find it in their best interest to reduce the cost of health care by reducing sickness.
In the long term, we need cost-effective, incentive-based policies to combat the growing threat of antibiotic resistance and preserve antibiotic effectiveness. The problem will grow larger if we fail to act
LA Times Letter-to-the-Editor
On February 20, ETC Principal Investigators Ramanan Laxminarayan and Anup Malani responded to an LA Times article, “'Superbug' staph reports required", with the following letter-to-the-editor:
“The California Department of Public Health's move to require local health departments to report severe infections originating outside healthcare facilities is an important first step in controlling the spread of antibiotic-resistant staph infections. But much more needs to be done.
Expanding reporting requirements to hospitals is important but will not fully address the problem of methicillin-resistant staphylococcus aureus, or MRSA, if hospitals have no incentive to provide accurate data.
Combining a reporting requirement with subsidies for testing patients coming into the hospital to see if they are carrying MRSA may encourage better infection control. A further step may be to encourage Medicare and Medicaid to refuse payment for infections acquired during hospitalizations. Currently, hospitals pass on the costs of most hospital-acquired infections to Medicare and commercial insurers, and may actually benefit from longer hospital stays."
Round-up of News on MRSA Trends
Numerous news outlets have covered Extending the Cure's new paper, "Hospitalizations and Deaths Caused by Methicillin-Resistant Staphylococcus aureus, United States, 1999-2005," by Eili Klein, David L. Smith, and Ramanan Laxminarayan. Reporters highlight the study's main findings that hospitalizations related to MRSA infections more than doubled between 1999 and 2005 and that minor skin and soft tissue infections caused by staph and MRSA commonly spread outside hospital walls are dramatically increasing.
Coverage appeared in outlets such as the LA Times (November 30), the Newark Star-Ledger (November 30), and Newsday.com (December 3) plus those linked below.
Selected Links:
US News & World Report, Healthday, Health Highlights,
November 29, 2007
MSNBC:
Orlando, November 30, 2007
St.Louis (video), November 30, 2007
Philadelphia (PDF), November 30, 2007
Modern Healthcare, December 3, 2007
(registration is required)
NewsInferno.com, December 6, 2007
University of Florida News, November 30, 2007
USA Today, December 3, 2007
Utne Reader
The November/December issue of Utne Reader discusses an “Extending the Cure” article from RFF's Resources magazine. The article highlights benefits that antibiotic innovation, education, and regulation could have on minimizing resistance.
Utne Reader (November 1)
Press Conference with Senator Durbin
On October 28, Senator Durbin held a press conference in Chicago to announce his new legislation, the Community and Healthcare-Associated Infections Reduction (CHAIR) Act of 2007. ETC principal investigators Ramanan Laxminarayan and Anup Malani advised on the bill’s language, and Dr. Malani participated in the press conference.
Senator Durbin’s News Release
Senator Durbin Introduces the CHAIR Act (S. 2278)
CQ Healthbeat
The July 23rd edition of Congressional Quarterly's HealthBeat notes the increasing ineffectiveness of antibiotics as discussed in ETC's recent briefings on Capitol Hill. The article references the remarks of ETC's Anup Malani on potential policy responses involving the FDA and Medicare.
CQ Healthbeat (July 23, subscription required)
Science Magazine
Donald Kennedy, Editor-in-Chief of Science, refers to Extending the Cure in a recent editorial calling for legislative provisions to revamp the FDA.
Science Magazine (June 22, subscription required)
American Society of Health-System Pharmacists
The American Society of Health-System Pharmacists released an article detailing Extending the Cure's new perspective on combating resistant microbes.
American Society of Health-System Pharmacists (June 15)
GrantWatch Online
GrantWatch, a feature of Health Affairs, reviewed Extending the Cure: Policy Responses to the Growing Threat of Antibiotic Resistance.
GrantWatch Online (May 31)
Voice of America
In two reports, Voice of America highlights mounting concerns over failing antibiotics and policy responses put forth by Extending the Cure.
VOA News (April 12)
VOA Radio "Our World" (April 14)
Wall Street Journal
On April 2, The Wall Street Journal ran a letter to the editor from ETC authors Anup Malani and Ramanan Laxminarayan.
Read the letter (subscription required)
Marketplace
On March 23, Helen Palmer interviewed Ramanan Laxminarayan, principal author of Extending the Cure: Policy Responses to the Growing Threat of Antibiotic Resistance, for American Public Media’s Marketplace.
The Epoch Times
Two editions of The Epoch Times ran feature stories discussing the challenge of antibiotic resistance and policy responses presented by Extending the Cure.
English Version (March 27)
Chinese Version (March 28)
ETC Congressional Briefing
July 20, 2007
The Robert Wood Johnson Foundation sponsored a Congressional briefing to discuss policy responses to antibiotic resistance as presented by Extending the Cure in its inaugural report. Extending the Cure offers a new framework recognizing antibiotic effectiveness as a vital national resource.
The briefing highlights the problem of misaligned incentives for addressing antibiotic resistance and emphasized the importance of a comprehensive approach, one that addresses both demand-side and supply-side challenges. A panel featuring two of the report's authors and a member of Extending the Cure's advisory committee provides statistics and stories stressing the severity of the issue and discusses potential policy options.
Speakers include:
Paul Tarini
Senior Program Officer, Robert Wood Johnson Foundation
Ramanan Laxminarayan
Senior Fellow, Resources for the Future
Anup Malani
Professor of Law, University of Chicago
Neil Fishman
Director of Antimicrobial Management, University of Pennsylvania Health System
Video of the briefing can be viewed at: http://www.rwjf.org/special/antibioticresistance
Kick-Off Event
April 30, 2007
Extending the Cure held a kick-off event at Resources for the Future to launch our project and inaugural report. This report, Extending the Cure: Policy Responses to the Growing Threat of Antibiotic Resistance, offers a fresh perspective on an emerging public health crisis–antibiotic resistance.
The report’s authors and senior advisers engaged in an exploration of the economic roots of the problem of antibiotic resistance and the ways that incentive-based policies and lessons from natural resource management can illuminate potential solutions.
Event Audio and Video
- To view the video files, you need Real Player or Windows Media Player. Get a free version at www.real.com or www.microsoft.com.
- The following audio file can be downloaded and saved with any music player: Listen to the entire event.
| Introduction: Stan Wellborn Director of Communications, Resources for the Future |
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| Ramanan Laxminarayan Senior Fellow, Resources for the Future |
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| Donald Kennedy President Emeritus, Stanford University, and Editor-in-Chief, Science |
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| Henry Masur President, Infectious Diseases Society of America |
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| Simon Levin Professor, Princeton University |
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| Question and Answer Session | ||
