Rather than banning antibiotic use in animals, why not make farmers pay extra for it? That’s the proposal in a recent issue of the New England Journal Of Medicine:
A user fee would have four important advantages over a ban. First, it would be relatively easy to administer, since it could be imposed at the manufacturing or importing stage.
Second, a user fee would deter low-value uses of antibiotics. Farms with good substitutes for antibiotics – for example, vaccinations or improved animal-management practices – would be discouraged from using antibiotics by higher prices, whereas farms with a high incidence of infections would probably continue to use antibiotics. The idea is to allow the farmer or veterinarian to decide whether the antibiotic confers enough benefits to make it worth the higher price, rather than relying on the intrusive, indiscriminate hand of government.
Third, user fees would generate revenues that could help to pay for rewards to companies that successfully develop new antibiotics, or to subsidize antibiotic-research investments, or to support antimicrobial stewardship and education programs. …
The fourth key benefit of the user-fee approach, as compared with a ban, is international replicability. Resistant bacteria do not respect national borders. Although the United States would benefit from imposing user fees on its own, an even better approach would be an international treaty to recognize the fragility of our common antibiotic resources and to impose user fees to be collected by national governments.
Maryn McKenna notes, “This isn’t the first time a user fee for antibiotics has been put forward”:
[L]ongtime readers may remember that the issue surfaced in spring 2011 during the observances for World Health Day. That proposal came from the Infectious Diseases Society of America – not an economists’ group, but a physicians’ association that has pressed for new incentives for drug development. At the time, one of their spokespeople compared a drug use-charge to the cost of the admission ticket for entering a national park – a fee paid to offset personal consumption of a jointly owned, over-used resource.
The Dish 