Colistin: An example of antimicrobial resistance
The antibiotic colistin is a prime example of increasing antimicrobial resistance (AMR). For many years it was rarely used on humans because of its harmful effects on the kidneys, although it has been used extensively in veterinary medicine. In recent years, however, colistin has again become a last-resort treatment for some patients with specific hard-to-treat bacterial infections. Worryingly, and reflecting the decreasing efficacy of antibiotics in general, the effectiveness of colistin is now also diminishing.
In November 2015, scientists announced the emergence of E. coli bacteria in China carrying the MCR-1 gene, which makes bacteria resistant to colistin. An infection with E. coli bacteria can cause gastroenteritis and even kidney failure. A study in The Lancet medical journal describes this as the ‘breach of the last group of antibiotics’. A woman from Pennsylvania in the US was also found with E. coli bacteria carrying the MCR-1 gene, although the patient proved not to be resistant to all antibiotics. As scientists have succeeded in transferring this colistin resistance to other bacteria, they are now more concerned than ever before that pan-resistant bacteria could develop.
Further development of antibiotic resistance is difficult to predict
Estimates suggest that the mortality rate due to antimicrobial resistance (AMR) might soar from 700,000 deaths every year worldwide to 10 million a year by 2050. What is more, the cumulative effect of AMR on economic performance could increase to US$ 100bn by 2050.
Nevertheless, these effects can be mitigated or even prevented altogether if new antibiotics are developed and other methods for fighting infectious diseases, such as genetic engineering, become a reality.
What does the increasing antibiotic resistance mean for life and health insurance companies?
This means that treatment costs are expected to increase for health insurance providers. Comparatively cheap antibiotics, such as penicillin, need to be replaced by antibiotics that are either more costly or expose the patients to more side effects which, in turn, generate additional treatment costs. New (and desperately needed) antimicrobial drugs and therapies to fight infectious diseases also tend to be significantly more expensive than established therapies. Other consequences of AMR could include longer periods of hospitalisation and additional costs for diagnostic tests.
Moreover, AMR will have significant effects on the healthcare infrastructure, though these are more difficult to calculate in terms of costs.
Antibacterial resistance is an example of an emerging medical risk that may affect the life and health insurance industry in different ways. However, the exact consequences are difficult to predict.
They could range from a return to a pre-antibiotic era to the development of a completely new drug that will mitigate or even prevent AMR development.
Click here to find out what specific health risks exist and how increasing antimicrobial resistance can be prevented.
Tackling Drug-Resistant Infections Globally: Final Report And Recommendations - The Review On Antimicrobial Resistance, Vorsitz: Jim O’Neill, Executive Summary, S. 10,
http://amr-review.org/ Emergence of plasmid-mediated colistin resistance mechanism MCR-1 in animals and human beings in China: a microbiological and molecular biological study, The Lancet: http://www.thelancet.com/journals/laninf/article/PIIS1473-3099(15)00424-7/abstract