The path of least resistance: Paying for antibiotics in non-human uses

•Antibiotics are used in livestock, pets, aquaculture, and crops and have great variation in value.•User fees are preferable to a ban of non-human uses of antibiotics.•The article calculates the scale of user fees required to raise $500 million annually.

Antibiotic resistance is a critical threat to human and animal health. Despite the importance of antibiotics, regulators continue to allow antibiotics to be used in low-value applications - subtherapeutic dosing in animals, and spraying tobacco plants for blue mold, for example - where the benefits are unlikely to outweigh the costs in terms of increased resistance. We explore the application of a user fee in non-human uses of antibiotics. Such a fee would efficiently deter low value uses while also providing funding to support the development of the urgently needed new antibiotics.