Using clinical data from a previous study, and outcomes data from the literature, the authors modelled the short-term perinatal (12-month time horizon) incremental direct costs and outcomes from a government (as the primary third-party funder) perspective for chlamydia screening. Costs were derived from the Medicare Benefits Schedule, Pharmaceutical Benefits Scheme, and average cost-weights reported for hospitalisations classified according to the Australian refined diagnosis-related groups.
Assuming a chlamydia prevalence rate of 3%, screening all antenatal women aged 16-25 years at their first antenatal visit compared with no screening was $34,931 per quality-adjusted life-years gained. Screening all women could result in cost savings when chlamydia prevalence was higher than 11%. The incremental cost-effectiveness ratios were most sensitive to the assumed prevalence of chlamydia, the probability of pelvic inflammatory disease, the utility weight of a positive chlamydia test and the cost of the chlamydia test and doctor's appointment.
From an Australian government perspective, chlamydia screening of all women aged 16-25 years old during one antenatal visit was likely to be cost-effective compared with no screening or selective screening, especially with increasing chlamydia prevalence.
Reference: Ong, J.J., Chen, M., Hocking, J., Fairley, C.K., Carter, R., Bulfone, L., Hsueh, A. Chlamydia screening for pregnant women aged 16-25 years attending an antenatal service: A cost-effectiveness study. BJOG. 2015 Aug 26. doi: 10.1111/1471-0528.13567. [Epub ahead of print]