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Open Access Green möglich sobald Postprint bei der ZB eingereicht worden ist.
Chlamydia screening is not cost-effective at low participation rates: Evidence from a repeated register-based implementation study in the Netherlands.
Sex. Transm. Dis. 91, 423-429 (2015)
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 (16-29 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. 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.
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Publikationstyp
Artikel: Journalartikel
Dokumenttyp
Wissenschaftlicher Artikel
Schlagwörter
Chlamydia Trachomatis ; Cost-effectiveness ; Mathematical Model ; Screening; Trachomatis Infections; Economic Evaluations; Controlled-trial; Programs; Disease
ISSN (print) / ISBN
0148-5717
e-ISSN
1537-4521
Zeitschrift
Sexually Transmitted Diseases
Quellenangaben
Band: 91,
Heft: 6,
Seiten: 423-429
Verlag
Lippincott Williams & Wilkins
Verlagsort
London
Begutachtungsstatus
Peer reviewed