OBJECTIVE: The objective of this study was to estimate the cost and cost-effectiveness of opportunistic screening for Chlamydia trachomatis in Ireland. METHODS: Prospective cost analysis of an opportunistic screening programme delivered jointly in three types of healthcare facility in Ireland. Incremental cost-effectiveness analysis was performed using an existing dynamic modelling framework to compare screening to a control of no organised screening. A healthcare provider perspective was adopted with respect to costs and included the costs of screening and the costs of complications arising from untreated infection. Two outcome measures were examined: major outcomes averted, comprising cases of pelvic inflammatory disease, ectopic pregnancy and tubal factor infertility in women, neonatal conjunctivitis and pneumonia, and epididymitis in men; and quality-adjusted life-years (QALY) gained. Uncertainty was explored using sensitivity analyses and cost-effectiveness acceptability curves. RESULTS: The average cost per component of screening was estimated at €26 per offer, €66 per negative case, €152 per positive case and €74 per partner notified and treated. The modelled screening scenario was projected to be more effective and more costly than the control strategy. The incremental cost per major outcomes averted was €6093, and the incremental cost per QALY gained was €94,717. For cost-effectiveness threshold values of €45,000 per QALY gained and lower, the probability of the screening being cost effective was estimated at <1%. CONCLUSIONS: An opportunistic chlamydia screening programme, as modelled in this study, would be expensive to implement nationally and is unlikely to be judged cost effective by policy makers in Ireland.
OBJECTIVE: The objective of this study was to estimate the cost and cost-effectiveness of opportunistic screening for Chlamydia trachomatis in Ireland. METHODS: Prospective cost analysis of an opportunistic screening programme delivered jointly in three types of healthcare facility in Ireland. Incremental cost-effectiveness analysis was performed using an existing dynamic modelling framework to compare screening to a control of no organised screening. A healthcare provider perspective was adopted with respect to costs and included the costs of screening and the costs of complications arising from untreated infection. Two outcome measures were examined: major outcomes averted, comprising cases of pelvic inflammatory disease, ectopic pregnancy and tubal factor infertility in women, neonatal conjunctivitis and pneumonia, and epididymitis in men; and quality-adjusted life-years (QALY) gained. Uncertainty was explored using sensitivity analyses and cost-effectiveness acceptability curves. RESULTS: The average cost per component of screening was estimated at €26 per offer, €66 per negative case, €152 per positive case and €74 per partner notified and treated. The modelled screening scenario was projected to be more effective and more costly than the control strategy. The incremental cost per major outcomes averted was €6093, and the incremental cost per QALY gained was €94,717. For cost-effectiveness threshold values of €45,000 per QALY gained and lower, the probability of the screening being cost effective was estimated at <1%. CONCLUSIONS: An opportunistic chlamydia screening programme, as modelled in this study, would be expensive to implement nationally and is unlikely to be judged cost effective by policy makers in Ireland.
Authors: G I J G Rours; Tamar Anne Smith-Norowitz; Jared Ditkowsky; Margaret R Hammerschlag; R P Verkooyen; R de Groot; H A Verbrugh; M J Postma Journal: Pathog Glob Health Date: 2016 Oct - Dec Impact factor: 2.894
Authors: Parastu Kasaie; Christina M Schumacher; Jacky M Jennings; Stephen A Berry; Susan A Tuddenham; Maunank S Shah; Eli S Rosenberg; Karen W Hoover; Thomas L Gift; Harrell Chesson; Danielle German; David W Dowdy Journal: BMJ Open Date: 2019-03-04 Impact factor: 2.692
Authors: Boris V Schmid; Eelco A B Over; Ingrid V F van den Broek; Eline L M Op de Coul; Jan E A M van Bergen; Johan S A Fennema; Hannelore M Götz; Christian J P A Hoebe; G Ardine de Wit; Marianne A B van der Sande; Mirjam E E Kretzschmar Journal: PLoS One Date: 2013-03-20 Impact factor: 3.240
Authors: Ingrid V van den Broek; Otilia Sfetcu; Marianne A van der Sande; Berit Andersen; Björn Herrmann; Helen Ward; Hannelore M Götz; Anneli Uusküla; Sarah C Woodhall; Shelagh M Redmond; Andrew J Amato-Gauci; Nicola Low; Jan E van Bergen Journal: Eur J Public Health Date: 2015-10-24 Impact factor: 3.367
Authors: Sarah Kerry-Barnard; Susie Huntington; Charlotte Fleming; Fiona Reid; S Tariq Sadiq; Vari M Drennan; Elisabeth Adams; Pippa Oakeshott Journal: BMC Health Serv Res Date: 2020-04-16 Impact factor: 2.655