Olof Lindahl

Research Projects

IDx: An exploration of regulatory, corporate, relational, and technical barriers to uptake of diagnostics in the fight against AMR

The IDx project seeks to contribute to a greater understanding of the barriers to uptake of AMR diagnostics in different clinical settings. Understanding these barriers will support removing obstacles to increased use of diagnostics for surveillance and prescription.

The IDx project is a collaboration between Uppsala University and the Karolinska Institute, Sweden; the industry association BEAM Alliance, France, Université de Laval, Canada, and the University of Cape Town, South Africa to address these issues. The project work has also consulted with international experts and policymakers in the field of diagnostics on challenges to implementation. In so doing, the research team has studied regulations, reimbursements systems, companies developing diagnostics technologies, and hospitals using, or not using, them to identify challenges to the uptake of new diagnostic technologies.

The findings from the project show, for example, how in high-income clinical settings, barriers concern government regulation of diagnostics development, procurement, and use, along with the private and public financing available for diagnostics in different stages of commercialization. In low-income health care settings, these issues are important yet overshadowed by the lack of resources and infrastructure for the use of diagnostics. As have the importance of governments to have a long-term prioritization of diagnostic capability in order to be able to detect and monitor AMR. In addition, the importance and particular benefits of collaborations between developers of diagnostics, developers of antibiotics, and the hospitals using both in combiation have been analyzed. Important findings moreover revolve around how the new regulation may hinder innovation that normally derives from the creation of lab-developed tests. Lastly, this work identified several hospital-centered barriers to uptake, such as the perceived complexity of new diagnostics, lack of trust in test results, and uncertainty about impact on user and local organization.

The most important impact of our project is the one caused by the spreading of this much needed knowledge to both companies developing AMR diagnostics technologies, to hospitals using them, and to public policy makers and regulators who might be able to support the spread of these new AMR diagnostics technologies.

New Economic Models for Antibiotics R&D

A topic of particular importance is the effectiveness of new economic models to incentivize antibiotic R&D. Through the work of entities such as DRIVE-AB and the O’Neill Commission on AMR, we today have a fair idea of what new economic models are available for policy makers to incentivize antibiotics R&D. However, we know very little about the actual effectiveness of these new models. Being an empirical field, the issue of investigating the effectiveness of such models and understanding why some work while others don’t, or why some work under certain condition or in certain environments thus constitutes the research front on economic models in relation to antibiotic resistance. Moreover, while the various new economic models already proposed does much to address the challenges facing innovation in antibiotics, there are considerable gaps when it comes to, among other things, incentivizing the prudent use of new drugs to ensure their long-term efficacy. This research interest practically translates into developing and evaluating additional new economic models that not only incentivizes innovation, but also prudent use.

Related published research

1. Morel, C. M., Lindahl, O., & Özenci, V. (2020). Lessons from COVID-19 on the role of the state and the market in providing early testing. Journal of Global Health, 10(2), 020330.
2. Beam Alliance (2023) The Issues Faced by SMEs Developing Innovative AMR Diagnostics, Reflection Paper, September 5, 2023
3. Hermans, L., Centner, C.M., Morel, C.M., Mbamalu, O., Bonaconsa, C., Ferreyra, C., Lindahl, O. & Mendelson, M. (2024). Point-of-Care Diagnostics for Infection and Antimicrobial Resistance in Sub-Saharan Africa – A Narrative Review. International Journal of Infectious Diseases
   
4. Lorcy, A., Garnier, A., & Dubé, È. (2024). Factors associated with the the implementation and adoption of point-of-care diagnostic tests to help fight against AMR in Quebec, Canada: A qualitative study. Canadian Journal of Infection Control, 39(2), pp97-103
5. Rahman, S., Lindahl, O., Morel, C. M., & Hollis, A. (2021). Market concentration of new antibiotic sales. The Journal of Antibiotics, 1-3.
6. Morel, C., Lindahl, O., Harbarth, S., de Kraker, M., Edwards, S., & Hollis, A. (2020). ‘Industry incentives and antibiotic resistance: an introduction to the antibiotic susceptibility bonus.’ Journal of Antibiotics
   
7. Ciabuschi, F., Baraldi, E. & Lindahl, O. (2020). ‘Joining Forces to Prevent the Antibiotic Resistance Doomsday Scenario. The Rise of Antibiotics International Multisectorial Partnerships as a New Governance Model.’ Academy of Management Perspectives
8. Baraldi, E., Ciabuschi, F., Lindahl, O., & Callegari, S. (2019) ‘Supporting innovation against the threat of antibiotic resistance: Exploring the impact of public incentives on firm performance and entrepreneurial orientation’, Journal of Business Research
9. Baraldi, E., Lindahl, O., Savic, M., Findley, D., & Årdal, C., (2018). ‘Antibiotic Pipeline Coordinators’. The Journal of Law, Medicine, & Ethics
10. Ciabuschi, F., & Lindahl, O. (2018). The Decline of Innovation in the Antibiotics Industry and the Global Threat of Antibiotic Resistance: When Entrepreneurial Efforts are Not Enough. In Entrepreneurship and the Industry Life Cycle (pp. 205-229). Springer, Cham.
11. Okhravi, C., Callegari, S., McKeever, S., Kronlid, C., Baraldi, E., Lindahl, O., and Ciabuschi, F. (2018). ‘Simulating Market Entry Rewards for Antibiotics Development’, the Journal of Law, Medicine & Ethics