Prediction of Costs, Effectiveness, and Disease Control of a Population-Based Program Using Home Sampling for Diagnosis of Urogenital Chlamydia trachomatis Infections

Abstract

Home sampling should be considered a relevant alternative to the current practice of in-office screening.

The cost and cost-effectiveness of opportunistic screening forChlamydia trachomatisin Ireland

“…For example, as in the studies by Roberts et al 25 and Adams et al ,3 we adopted a probability of 10% for the progression from undiagnosed female chlamydia infection to pelvic inflammatory disease. This is in contrast to the studies by Andersen et al ,21 Gift et al ,22 Welte et al 23 and deVries et al ,24 which adopted equivalent probabilities of 25%, 20%, 20% and 15%, respectively. In all studies, this parameter has been shown to be a major influence on cost-effectiveness, and recent evidence appears to support the more conservative approach used here in the modelling of this relationship 26.…”

“…Our cost-effectiveness results can also be compared to those from other studies, which, using alternative dynamic modelling frameworks, reported conflicting results for the cost-effectiveness of chlamydia screening strategies in various countries. Andersen et al ,21 Gift et al ,22 Welte et al 23 and deVries et al 24 individually found that various forms of opportunistic and proactive screening were cost effective in Denmark, the USA and the Netherlands. Conversely, Roberts et al 25 found that proactive register-based screening in the UK was not cost effective.…”

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

“…All future disease states were counted in the year of asymptomatic infection, applying discounting to correct for the age-specific expected delay between infection and its consequences for pregnancy, infertility and offspring. The model was an updated version of a previously developed model,8 9 15 with two additions: (1) the option to perform probabilistic sensitivity analysis and (2) the inclusion of direct effects for treated persons. In order to define the total costs of Chlamydial infections detected in different scenarios, we multiplied the number of infections and sequelae by their estimated costs.…”

“…The costs of screening were estimated based on the actual programme budgets of STI AIDS Netherlands, the central coordinating organisation for the CSI project, and the three regional Public Health Services involved in CSI. Costs for the treatment of Chlamydia and its sequelae, as well as costs associated with productivity losses, were updated and adapted from previous models8 9 15 or taken from recent literature. To calculate outcomes in terms of QALYs, we used data on the duration of MO and quality of life losses associated with MO, as provided by Stratton et al 16.…”

Screening op urogenitale Chlamydia trachomatis-infecties: de stand van zaken

“…Dynamische modellen lijken hier een uitweg te bieden en geven over het algemeen sneller kostenbesparingen. [24][25][26] Bovendien worden aanzienlijke prijsreducties in testprijzen verwacht bij grootschaliger gebruik en kunnen laboratoriumtechnieken zoals 'poolen' van testmonsters de testkosten van een screeningsprogramma met de helft reduceren. 27 10.…”