Chlamydia screening is not cost-effective at low participation rates: evidence from a repeated register-based implementation study in The Netherlands

Sexually Transmitted Infections
G Ardine de WitMirjam E E Kretzschmar

Abstract

In three pilot regions of The Netherlands, all 16-29 year olds were invited to participate in three annual rounds of Chlamydia screening. The aim of the present study is to evaluate the cost-effectiveness of repeated Chlamydia screening, based on empirical data. A mathematical model was employed to estimate the influence of repeated screening on prevalence and incidence of Chlamydial infection. A model simulating the natural history of Chlamydia was combined with cost and utility data to estimate the number of major outcomes and quality-adjusted life-years (QALYs) associated with Chlamydia. Six screening scenarios (16-29 years annually; 16-24 years annually; women only; biennial screening; biennial screening women only; screening every five years) were compared with no screening in two sexual networks, representing both lower ('national network') and higher ('urban network') baseline prevalence. Incremental cost-effectiveness ratios (ICERs) for the different screening scenarios were estimated. Uncertainty and sensitivity analyses were performed. In all scenarios and networks, cost per major outcome averted are above €5000. Cost per QALY are at least €50,000. The default scenario as piloted in the Netherlands was least cost-effe...Continue Reading

References

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Citations

Oct 6, 2016·The European Journal of Contraception & Reproductive Health Care : the Official Journal of the European Society of Contraception·Georgina F van den BergEline L M Op de Coul
Apr 21, 2016·PloS One·Alies van LierHester E de Melker
Aug 27, 2015·International Journal of Environmental Research and Public Health·Kevin TheunissenNicole Dukers-Muijrers
Jan 22, 2020·Health Promotion Practice·Heather McCannKristina Wilson
Dec 4, 2019·The Journal of School Nursing : the Official Publication of the National Association of School Nurses·Li Yan WangKristina Wilson
Aug 26, 2017·The Journal of Infectious Diseases·Matthew R GoldenGail Bolan
Dec 10, 2015·Sexually Transmitted Diseases·Joan M Chow, Heidi M Bauer
May 29, 2021·Sexually Transmitted Infections·Jan E A M van BergenBirgit H B van Benthem

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