Document Detail


The cost and cost-effectiveness of opportunistic screening for Chlamydia trachomatis in Ireland.
MedLine Citation:
PMID:  22213681     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
ObjectiveThe objective of this study was to estimate the cost and cost-effectiveness of opportunistic screening for Chlamydia trachomatis in Ireland.MethodsProspective cost analysis of an opportunistic screening programme delivered jointly in three types of healthcare facility in Ireland. Incremental cost-effectiveness analysis was performed using an existing dynamic modelling framework to compare screening to a control of no organised screening. A healthcare provider perspective was adopted with respect to costs and included the costs of screening and the costs of complications arising from untreated infection. Two outcome measures were examined: major outcomes averted, comprising cases of pelvic inflammatory disease, ectopic pregnancy and tubal factor infertility in women, neonatal conjunctivitis and pneumonia, and epididymitis in men; and quality-adjusted life-years (QALY) gained. Uncertainty was explored using sensitivity analyses and cost-effectiveness acceptability curves.ResultsThe average cost per component of screening was estimated at €26 per offer, €66 per negative case, €152 per positive case and €74 per partner notified and treated. The modelled screening scenario was projected to be more effective and more costly than the control strategy. The incremental cost per major outcomes averted was €6093, and the incremental cost per QALY gained was €94 717. For cost-effectiveness threshold values of €45 000 per QALY gained and lower, the probability of the screening being cost effective was estimated at <1%.ConclusionsAn opportunistic chlamydia screening programme, as modelled in this study, would be expensive to implement nationally and is unlikely to be judged cost effective by policy makers in Ireland.
Authors:
Paddy Gillespie; Ciaran O'Neill; Elisabeth Adams; Katherine Turner; Diarmuid O'Donovan; Ruairi Brugha; Deirdre Vaughan; Emer O'Connell; Martin Cormican; Myles Balfe; Claire Coleman; Margaret Fitzgerald; Catherine Fleming
Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2012-1-2
Journal Detail:
Title:  Sexually transmitted infections     Volume:  -     ISSN:  1472-3263     ISO Abbreviation:  -     Publication Date:  2012 Jan 
Date Detail:
Created Date:  2012-1-3     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9805554     Medline TA:  Sex Transm Infect     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Affiliation:
National University of Ireland Galway, Ireland.
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