Modelling the healthcare costs of an opportunistic chlamydia screening programme.
OBJECTIVE
To estimate the average cost per screening offer, cost per testing episode and cost per chlamydia positive episode for an opportunistic chlamydia screening programme (including partner management), and to explore the uncertainty of parameter assumptions, based on the costs to the healthcare system.


METHODS
A decision tree was constructed and parameterised using empirical data from a chlamydia screening pilot study and other sources. The model was run using baseline data from the pilot, and univariate and multivariate sensitivity analyses were conducted.


RESULTS
The total estimated cost for offering screening over 12 months to 33,215 females aged 16-24 was 493,412 pounds . The average cost (with partner management) was 14.88 pounds per screening offer (90% credibility interval (CI) 10.34 to 18.56), 21.83 pounds per testing episode (90% CI 18.16 to 24.20), and 38.36 pounds per positive episode (90% CI 33.97 to 42.25). The proportion of individuals accepting screening, the clinician (general practitioner/nurse) time and their relative involvement in discussing screening, the test cost, the time to notify patients of their results, and the receptionist time recruiting patients had the greatest impact on the outcomes in both the univariate and multivariate sensitivity analyses.


CONCLUSIONS
Results from this costing study may be used to inform resource allocation for current and future chlamydia screening programme implementation.
Statistics, Modelling and Economics Department, Communicable Disease Surveillance Centre, Health Protection Agency, 61 Colindale Avenue, London NW9 5EQ, UK. elisabeth.adams@hpa.org.uk
E J
EJ
Adams
D S
DS
LaMontagne
A R
AR
Johnston
J M
JM
Pimenta
K A
KA
Fenton
W J
WJ
Edmunds
D000293:Adolescent; D000328:Adult; D002690:Chlamydia Infections / Q000191:economics / Q000517:prevention & control*; D003625:Data Collection; D003661:Decision Support Techniques; D003663:Decision Trees; D005260:Female; D017048:Health Care Costs; D006801:Humans; D008403:Mass Screening / Q000191:economics / Q000379:methods*; D018803:Models, Economic; D015999:Multivariate Analysis; D010865:Pilot Projects