Can antimicrobial resistance disrupt health insurance models?

Antimicrobial resistance (AMR) is a growing global health crisis that not only endangers lives but also puts immense pressure on healthcare systems and insurance models. As the misuse and overuse of antibiotics accelerate resistance, insurers must adapt to the rising costs and evolving risks that AMR presents.

According to the U.S. Centers for Disease Control and Prevention (CDC), antibiotic resistance can add as much as $1,400 to hospital bills for patients with bacterial infections – exponentially increasing financial burdens.

Natalie Kelly, head of global underwriting, claims, and R&D at Swiss Re, underscored that tackling AMR is a win-win for both policyholders and the insurance industry.

“Preventive services against AMR benefit both policyholders and insurers by saving lives, reducing costs, and lowering healthcare utilization,” she said. “By minimizing AMR risks, we can help safeguard essential medications for future generations.”

The impact of AMR on health insurance models

Causing nearly 5 million deaths in 2019 alone, AMR is rapidly emerging as an urgent public health threat, with profound implications for health insurance models.

Health insurers must brace for rising costs as complex treatment regimens become necessary to combat infections caused by resistant bacteria.

“The rise of antimicrobial resistance will lead to escalating long-term healthcare expenses as costly treatment options are explored for individuals with AMR,” Kelly said.

“Insurers must adapt their models to cover access to these treatments as the threat continues to rise.”

These alternative treatments often involve "last resort" antibiotics, reserved for infections that do not respond to standard therapies. While essential for treating resistant infections, these medications are particularly expensive and come with significant challenges, further increasing healthcare costs. Their limited availability and high production expenses impose a substantial financial burden on healthcare systems and insurers alike.

Preventative measures to mitigate AMR risk

Insurers and brokers can implement several key strategies to mitigate the risk of AMR:

1. Education and Awareness Campaigns: Collaborating with healthcare providers to promote education and awareness is crucial for encouraging responsible antibiotic use and preserving the effectiveness of existing medications. Kelly emphasized that increased awareness from insurers can influence prescribing practices. “Insurers can support policyholders with informational resources such as factsheets, reminding them to adhere strictly to their prescribed treatments,” she said.
2. Data Collection and Analysis: Insurers can partner with governments and healthcare organizations to collect comprehensive data on antimicrobial resistance (AMR) and antibiotic prescription patterns. This collaboration is vital in establishing a robust monitoring framework. “AMR suffers from under-reporting and under-testing. Without sufficient levels of monitoring and surveillance, an outbreak may occur with spread, without much oversight,” Kelly said.
3. Promote Vaccination Coverage: Supporting initiatives that improve vaccination rates can protect policyholders from common diseases that may lead to hospitalization, “where the risk of contracting or spreading resistant bacteria is heightened,” Kelly said. By promoting the benefits of vaccination, insurers can play a vital role in enhancing public health and minimizing the impact of AMR within the healthcare system.