Chlamydia screening is not cost-effective at low participation rates: evidence from a repeated register-based implementation study in The Netherlands.
Sex Transm Infect
; 91(6): 423-9, 2015 Sep.
Article
en En
| MEDLINE
| ID: mdl-25759475
ABSTRACT
OBJECTIVE:
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.METHODS:
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 (16-29â years annually; 16-24â years annually; women only; biennial screening; biennial screening women only; screening every fiveâ 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.RESULTS:
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-effective, with ICERs of 232,000 in the national and 145,000 in the urban sexual network. Results were robust in sensitivity analyses.CONCLUSIONS:
It is unlikely that repeated rounds of Chlamydia screening will be cost-effective. Only at high levels of willingness to pay for a QALY (>50,000) screening may be more cost-effective than no screening.Palabras clave
Texto completo:
1
Colección:
01-internacional
Banco de datos:
MEDLINE
Asunto principal:
Participación del Paciente
/
Infecciones por Chlamydia
/
Chlamydia trachomatis
/
Tamizaje Masivo
Tipo de estudio:
Clinical_trials
/
Diagnostic_studies
/
Health_economic_evaluation
/
Incidence_studies
/
Prognostic_studies
/
Risk_factors_studies
/
Screening_studies
Límite:
Adolescent
/
Adult
/
Female
/
Humans
/
Male
País/Región como asunto:
Europa
Idioma:
En
Revista:
Sex Transm Infect
Asunto de la revista:
DOENCAS SEXUALMENTE TRANSMISSIVEIS
Año:
2015
Tipo del documento:
Article
País de afiliación:
Países Bajos