Host Dr. Jonathan Ryder speaks with Dr. Jamie Wagner and Dr. Sheetal Kandiah about the macro- and micro-influences driving antimicrobial costs. They explore how the ACA, pharmacy benefit managers, formulary restrictions, and socioeconomic disparities shape access and prescribing patterns. The discussion highlights real-world challenges for stewardship programs and practical steps to improve affordability and equity in antimicrobial use, with a look ahead at future reforms.