Our transferability decision chart is a transparent and user-friendly tool for assessing and improving the transferability of economic evaluation results. A state of the art description of the methodology in a study, providing detailed components for calculation, is not only essential for determining its transferability but also for improving it via modelling adjustments.

Inclusion of partner pharmacotherpy provides significant improvements in overall cost-effectiveness of the CT screening program among women aged 15 to 29. Partner pharmacotherapy lowers net costs per major outcome averted to the realm where implementation of the screening program should be considered. Considering the cost-saving potential, male partner pharmacotherapy should be pursued within the broader framework of a CT screening program for women. Reinfection should be included in any future pharmacoeconomic model of CT screening. Further work on this type of model should also be directed to linking cost-effectiveness to epidemiological models for the long-term spread of infectious diseases in populations.

We estimate the cost-effectiveness of screening women for asymptomatic infection with Chlamydia trachomatis in general practice.A decision-analysis model was constructed for health effects of the program: averted pelvic inflammatory disease, chronic pelvic pain, ectopic pregnancy, infertility, and neonatal pneumonia (major outcomes averted).We explicitly included reinfection due to failed partner referral in the model. Cost-effectiveness estimates included direct and indirect costs.At current test costs -of US$ 17 for ligase chain reaction test on urine -only screening women aged 15-19 years is cost saving.Net costs per cured woman and major outcome averted for screening women younger than 30 are below US$ 150 and US$ 410, respectively.These results are sensitive to reinfection.We conclude that explicit inclusion of reinfection is relevant for valid estimations of cost-effectiveness of screening for C. trachomatis.Based on costeffectiveness considerations, we suggest implementation of a screening program in Amsterdam for sexually active women younger than 30 years.

Chlamydia trachomatis is the most common, curable, sexually transmitted disease in many Western countries, leading to severe sequelae, such as infertility and ectopic pregnancy. As most chlamydial infections are asymptomatic, screening programs seem to be an attractive public health measure. MEDLINE, EMBASE, the Health Economic Evaluation Database and the National Health Service Economic Evaluation Database were searched for economic evaluations of Chlamydia trachomatis screening programs. Key factors influencing the cost-effectiveness are identified and assessed, such as screening strategy, test system and treatment regimen. Standard and new methodological approaches for assessing the cost-effectiveness are presented and future developments in the field are predicted. The most cost-effective screening approaches are compared with the recommendations of international guidelines.

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