Evidence map›Paper›PMID 41533227›Full record

ArticleApplied health economics and health policy2026

Estimation of 'spectrum value': A discrete choice experiment to investigate the willingness-to-pay for narrow-spectrum based on other antimicrobial characteristics.

Nadine T Hillock, Gang Chen, Tracy L Merlin, Jennie Louise, John Turnidge, Jonathan Karnon

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Article in Applied health economics and health policy, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

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1 · What the graph read from it

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2 · The registry

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3 · Its place in the literature

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4 · The record

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5 · Who and what money

Authors and funding

6 authors.

Nadine T HillockSchool of Public Health, College of Health, Adelaide University, Adelaide, SA, 5000, Australia. nadine.hillock@adelaide.edu.au.ORCID 0000-0003-2245-3740
Gang ChenMelbourne School of Population and Global Health, University of Melbourne, Victoria, 3010, Australia.
Tracy L MerlinSchool of Public Health, College of Health, Adelaide University, Adelaide, SA, 5000, Australia.
Jennie LouiseWomen's and Children's Hospital Research Centre, South Australian Health and Medical Research Institute, Adelaide, SA, 5000, Australia.
John TurnidgeCollege of Health, Adelaide University, Adelaide, SA, 5000, Australia.
Jonathan KarnonCollege of Medicine and Public Health, Flinders University, Bedford Park, SA, 5042, Australia.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundNarrow-spectrum antimicrobials are likely to drive fewer antimicrobial resistances. However, they may be more expensive than broad-spectrum alternatives.

objectiveTo determine the preferences of antimicrobial stewardship (AMS) experts regarding antimicrobial choice relative to relevant pharmacological and economic attributes, and how those attributes impact their willingness-to-pay for narrow-spectrum of activity.

methodsTwo discrete choice experiments (DCEs), consisting of six pharmacological and economic attributes, were administered via an online survey to Australian infectious disease physicians, clinical microbiologists and hospital AMS pharmacists. Respondents were asked to complete each DCE from a public hospital perspective, assuming 100 or 1000 patients would be treated each year, respectively. A conditional logit model was used to analyse the DCE data.

results155 respondents participated in one or both DCEs. Antimicrobial price, spectrum of activity, administration route, and public funding significantly affected drug choice in both scenarios (p < 0.001). Whether the antimicrobial was a novel class did not significantly impact choice. As the price of a narrow-spectrum antimicrobial increased, it became less preferred compared to a broad-spectrum cheaper alternative. With all other attributes being equal, participants were willing to pay an additional AU$862 for the narrow-spectrum option (95% CI $726-$998).

conclusionsWhile narrow-spectrum antimicrobials are preferred for targeted therapy by health practitioners with AMS expertise, price significantly influenced drug choice. Willingness-to-pay values reflect the knowledge and experience of AMS experts who are best-placed to gauge the opportunity costs of paying more for narrow-spectrum antimicrobials. These findings can inform the quantification of spectrum-value for health-system funding decisions.

Indexed as

Anti-Infective AgentsAntimicrobial StewardshipChoice BehaviorAdultAustraliaFemaleHumansMaleSurveys and QuestionnairesAnti-Infective Agents

Identifiers

PMID41533227
PMCPMC13102792

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LicenceCC BY-NC
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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.