Henrike J Vriend1, Anna K Lugnér, Maria Xiridou, Maarten F Schim van der Loeff, Maria Prins, Henry J C de Vries, Suzanne E Geerlings, Jan M Prins, Bart J A Rijnders, Maaike G van Veen, Johannes S A Fennema, Maarten J Postma, Marianne A B van der Sande. 1. aCentre for Infectious Disease Control, National Institute for Public Health and the Environment (RIVM), Bilthoven bDepartment of Internal Medicine, Division of Infectious Diseases, Center for Infection and Immunity Amsterdam (CINIMA), Academic Medical Center, Amsterdam cDepartment of Dermatology, Academic Medical Center, Amsterdam dSTI Outpatient Clinic, Public Health Service of Amsterdam, Amsterdam eResearch Department, Cluster for Infectious Diseases, Public Health Service of Amsterdam, Amsterdam fInternal Medicine and Infectious Diseases, Erasmus University Medical Center, Rotterdam gUnit of PharmacoEpidemiology and PharmacoEconomics, Department of Pharmacy, University of Groningen, Groningen hJulius Center, University Medical Center, Utrecht, the Netherlands.
Abstract
OBJECTIVE: To estimate the cost-effectiveness of anorectal chlamydia screening among men who have sex with men (MSM) in care at HIV treatment centers. DESIGN: Transmission model combined with economic analysis over a 20-year period. SETTING AND PARTICIPANTS: MSM in care at HIV treatment centers. INTERVENTION: Once-yearly or twice-yearly screening for anorectal chlamydia among MSM in care at HIV treatment centers. MAIN OUTCOME MEASURES: Averted HIV and chlamydia infections; discounted quality-adjusted life-years and costs; incremental cost-effectiveness ratio (ICER). RESULTS: Costs will be saved by routine chlamydia screening of MSM in care at HIV treatment centers if these patients seek little or no screening elsewhere. Nonroutine screening is considerably more expensive than routine screening offered within a scheduled visit. Adding once-yearly chlamydia screening for MSM in care at HIV treatment centers is cost saving when 30% or fewer of those men seek once-yearly screening elsewhere (1.5 to 8.1 million euro saved). Twice-yearly routine screening at HIV treatment centers is cost-effective only when routine screening takes place without additional nonroutine screening (1.9 million euro saved). CONCLUSIONS: Adding annual chlamydia screening to the HIV consultation will be cost saving as long as only a limited proportion of men are nonroutinely screened. The ICER was most sensitive to the percentage of MSM that continue to be screened elsewhere.
OBJECTIVE: To estimate the cost-effectiveness of anorectal chlamydia screening among men who have sex with men (MSM) in care at HIV treatment centers. DESIGN: Transmission model combined with economic analysis over a 20-year period. SETTING AND PARTICIPANTS: MSM in care at HIV treatment centers. INTERVENTION: Once-yearly or twice-yearly screening for anorectal chlamydia among MSM in care at HIV treatment centers. MAIN OUTCOME MEASURES: Averted HIV and chlamydia infections; discounted quality-adjusted life-years and costs; incremental cost-effectiveness ratio (ICER). RESULTS: Costs will be saved by routine chlamydia screening of MSM in care at HIV treatment centers if these patients seek little or no screening elsewhere. Nonroutine screening is considerably more expensive than routine screening offered within a scheduled visit. Adding once-yearly chlamydia screening for MSM in care at HIV treatment centers is cost saving when 30% or fewer of those men seek once-yearly screening elsewhere (1.5 to 8.1 million euro saved). Twice-yearly routine screening at HIV treatment centers is cost-effective only when routine screening takes place without additional nonroutine screening (1.9 million euro saved). CONCLUSIONS: Adding annual chlamydia screening to the HIV consultation will be cost saving as long as only a limited proportion of men are nonroutinely screened. The ICER was most sensitive to the percentage of MSM that continue to be screened elsewhere.
Authors: Carolina J G Kampman; Janneke C M Heijne; Petronella H M Kistemaker-Koedijk; Femke D H Koedijk; Maartje Visser; Jeannine L A Hautvast Journal: BMJ Open Date: 2018-05-31 Impact factor: 2.692
Authors: J Leenen; C J P A Hoebe; R P Ackens; D Posthouwer; I H M van Loo; P F G Wolffs; N H T M Dukers-Muijrers Journal: BMC Infect Dis Date: 2020-12-04 Impact factor: 3.090
Authors: Nicole H T M Dukers-Muijrers; Julius Schachter; Genevieve A F S van Liere; Petra F G Wolffs; Christian J P A Hoebe Journal: BMC Infect Dis Date: 2015-11-17 Impact factor: 3.090
Authors: Geneviève A F S van Liere; Christian J P A Hoebe; Petra F G Wolffs; Nicole H T M Dukers-Muijrers Journal: BMC Infect Dis Date: 2014-05-19 Impact factor: 3.090