Opportunistische screening op genitale infecties met Chlamydia trachomatis onder de seksueel actieve bevolking van Amsterdam. IV. Kosteneffectiviteitsanalyse van screening uitgebreid met het oog op de specifieke dynamiek van een infectieziekte
Open

Onderzoek
18-03-2002
R. Welte, M. Kretzschmar, J.C. Jager, R. Leidl, J.A.R. van den Hoek en M.J. Postma

Opportunistic screening for genital infections with Chlamydia trachomatis among the sexually active population of Amsterdam. IV. Cost-effectiveness analysis of screening including the dynamics of the spread of an infectious disease in a population

To estimate cost effectiveness of opportunistic screening for Chlamydia trachomatis (CT) in sexually active persons in general practices in Amsterdam, the Netherlands.

Design.

Pharmacoeconomic model calculation.

Method.

In addition to the risk of CT infection and associated complications (such as ectopic pregnancy and infertility) and the costs of screening and CT complications, epidemiological data on the spread of CT was also included in the model calculation. On the basis of this calculation, an estimate was made of the net direct and indirect costs of screening for an avoided serious complication associated with CT infection.

Results.

Screening women in the age group 15-34 years was estimated to save costs compared with no screening. Adding men to a screening directed at women only would not save costs. Net costs were then estimated at approximately € 1000 - € 3000 per avoided serious complication, depending on the specific age group considered. The net costs of screening would be higher if the CT prevalence prior to screening was lower, if the screening period was shorter and if the rate of identified partners was lower. The costs would be less if the test costs were less and if there was a higher risk of complications.

Conclusion.

From a pharmacoeconomic point of view a CT-screening programme for sexually active women in Amsterdam can be recommended.