title: The cost and cost-effectiveness of expedited partner therapy compared with standard partner referral for the treatment of chlamydia or gonorrhea.
abstract: BACKGROUND
  Partner treatment is an important component of sexually transmitted disease control. Several randomized controlled trials have compared expedited partner treatment (EPT) to unassisted standard partner referral (SR). All of these trials found that EPT significantly increased partner treatment over SR, whereas some found that EPT significantly lowered reinfection rates in index patients.
  
  
  METHODS
  We collected cost data to assess the payer-specific, health care system, and societal-level cost of EPT and SR. We used data on partner treatment and index patient reinfection rates from 2 randomized controlled trials examining EPT and SR for patients diagnosed with chlamydia or gonorrhea. Additional elements were estimated or drawn from the literature. We used a Monte Carlo simulation to assess the impact on cost and effectiveness of varying several variables simultaneously, and calculated threshold values for selected variables at which EPT and SR costs per patient were equal.
  
  
  RESULTS
  From a health care system or societal perspective, EPT was less costly and it treated more partners than SR. From the perspective of an individual payer, EPT was less costly than SR if ≥32% to 37% of male index patients' female partners or ≥29% of female index patients' male partners received care from the same payer.
  
  
  CONCLUSIONS
  EPT has a lower cost from a societal or health care system perspective than SR and treats more partners. Individual payers may find EPT to be more costly than SR, depending on how many of their patients' partners receive care from the same payer.
authors: Centers for Disease Control and Prevention, Division of STD Prevention, Atlanta, GA 30333, USA. tgift@cdc.gov
authors: Thomas L
authors: TL
authors: Gift
authors: Patricia
authors: P
authors: Kissinger
authors: Hamish
authors: H
authors: Mohammed
authors: Jami S
authors: JS
authors: Leichliter
authors: Matthew
authors: M
authors: Hogben
authors: Matthew R
authors: MR
authors: Golden
mesh_terms: D000900:Anti-Bacterial Agents / Q000191:economics / Q000627:therapeutic use*; D002690:Chlamydia Infections / Q000188:drug therapy* / Q000191:economics / Q000453:epidemiology / Q000517:prevention & control; D016358:Contact Tracing / Q000379:methods; D003362:Cost-Benefit Analysis; D005260:Female; D006069:Gonorrhea / Q000188:drug therapy* / Q000191:economics / Q000453:epidemiology / Q000517:prevention & control; D017048:Health Care Costs; D006801:Humans; D008297:Male; D009010:Monte Carlo Method; D019057:Quality-Adjusted Life Years; D012017:Referral and Consultation / Q000191:economics*; D012747:Sexual Partners; D012749:Sexually Transmitted Diseases / Q000188:drug therapy* / Q000191:economics / Q000453:epidemiology / Q000517:prevention & control; D016896:Treatment Outcome
chemical_list: D000900:Anti-Bacterial Agents