Eine wohlfahrtsökonomische Analyse der Übernutzung patentfreier Antibiotika und deren Auswirkungen auf die Verbreitung resistenter Infektionserreger

Hospital-acquired infections have become a serious public health thread. The emergence and spread of multidrug-resistant organisms as a direct result of uses of broad-spectrum antibiotics may be be seen as a major driver of the incidence of this kind of infections. For many broad-spectrum antibiotics, however, generic substitutes became available in recent years leading to decreasing prices. The present work addresses the question which of the contrary effects cheaper medication and spread of multidrug-resistant organisms prevails from an economic perspective. Therefore, a partial equilibrium model is presented taking into account both the cost of medication as well as the impact of antibiotic use on the spread of resistant bacteria. In detail, the welfare effect of ciprofloxacin use was analyzed before and after patent expiration for the setting of a German tertiary care teaching hospital. Therefore, own-price elasticities of demand for ciprofloxacin were determined using a logit-type model of demand for differentiated goods. Finally, the welfare effect of the increasing demand for ciprofloxacin after patent expiration is calculated. The results of the analysis indicate that the effect cheaper medication is substantially overwhelmed by the additional costs imposed by the spread of multidrug-resistant organisms.