Healthcare and patient costs of a proactive chlamydia screening programme: the Chlamydia Screening Studies project.
OBJECTIVE
Most economic evaluations of chlamydia screening do not include costs incurred by patients. The objective of this study was to estimate both the health service and private costs of patients who participated in proactive chlamydia screening, using mailed home-collected specimens as part of the Chlamydia Screening Studies project.


METHODS
Data were collected on the administrative costs of the screening study, laboratory time and motion studies and patient-cost questionnaire surveys were conducted. The cost for each screening invitation and for each accepted offer was estimated. One-way sensitivity analysis was conducted to explore the effects of variations in patient costs and the number of patients accepting the screening offer.


RESULTS
The time and costs of processing urine specimens and vulvo-vaginal swabs from women using two nucleic acid amplification tests were similar. The total cost per screening invitation was 20.37 pounds (95% CI 18.94 pounds to 24.83). This included the National Health Service cost per individual screening invitation 13.55 pounds (95% CI 13.15 pounds to 14.33) and average patient costs of 6.82 pounds (95% CI 5.48 pounds to 10.22). Administrative costs accounted for 50% of the overall cost.


CONCLUSIONS
The cost of proactive chlamydia screening is comparable to those of opportunistic screening. Results from this study, which is the first to collect private patient costs associated with a chlamydia screening programme, could be used to inform future policy recommendations and provide unique primary cost data for economic evaluations.
Robinson
Suzanne
S
Health Economics Facility, Health Services Management Centre, University of Birmingham, 40 Edgbaston Park Road, Birmingham, UK. s.m.robinson@bham.ac.uk
Roberts
Tracy
T
Barton
Pelham
P
Bryan
Stirling
S
Macleod
John
J
McCarthy
Anne
A
Egger
Matthias
M
Sanford
Emma
E
Low
Nicola
N
D000293:Adolescent; D000328:Adult; D002690:Chlamydia Infections / Q000191:economics / Q000517:prevention & control*; D002692:Chlamydia trachomatis; D019411:Clinical Laboratory Techniques / Q000191:economics; D017281:Cost of Illness; D004739:England; D005194:Family Practice / Q000191:economics / Q000706:statistics & numerical data; D005260:Female; D017048:Health Care Costs; D006801:Humans; D008297:Male; D008403:Mass Screening / Q000191:economics*; D013222:State Medicine / Q000191:economics; D013997:Time Factors; D013996:Time and Motion Studies