Economics perspectives on understanding antimicrobial use and resistance: a scoping review from theory to practice

This scoping review shows that economics offers essential but still underused tools for understanding and addressing antimicrobial resistance (AMR). By synthesizing literature from 2023–2025, it maps four interconnected economic dimensions: (1) core theories such as public-goods dynamics, externalities, market failures and the tragedy of the commons that explain why antimicrobials are overused; (2) real-world market and behavioral dynamics, including supply–demand imbalances and clinical principal–agent problems; (3) policy levers ranging from regulation and fiscal instruments to behavioral-economics–informed stewardship; and (4) economic evaluation methods that help assess and predict the value and impact of interventions. The review argues that only multi-component, economically coherent strategies—rather than isolated measures—can realign short-term prescribing incentives with long-term antimicrobial preservation. It concludes that effective AMR mitigation requires much closer collaboration between economists, clinicians and policymakers to design policies that integrate economic realities with health security goals.