title: Chlamydia screening for pregnant women aged 16-25 years attending an antenatal service: a cost-effectiveness study.
abstract: OBJECTIVE
  Determine the cost-effectiveness of screening all pregnant women aged 16-25 years for chlamydia compared with selective screening or no screening.
  
  
  METHODS
  Cost effectiveness based on a decision model.
  
  
  METHODS
  Antenatal clinics in Australia.
  
  
  METHODS
  Pregnant women, aged 16-25 years.
  
  
  METHODS
  Using clinical data from a previous study, and outcomes data from the literature, we 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.
  
  
  METHODS
  Direct costs of screening and managing chlamydia complications, number of chlamydia cases detected and treated, and the incremental cost-effectiveness ratios were estimated and subjected to sensitivity analyses.
  
  
  RESULTS
  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.
  
  
  CONCLUSIONS
  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.
  
  
  CONCLUSIONS
  Chlamydia screening for all pregnant women aged 16-25 years during an antenatal visit is cost effective.
authors: Melbourne School of Population and Global Health, University of Melbourne, Parkville, Victoria, Australia.|Melbourne Sexual Health Centre, Carlton, Victoria, Australia.
authors: J J
authors: JJ
authors: Ong
authors: Melbourne Sexual Health Centre, Carlton, Victoria, Australia.|Central Clinical School Monash University, Clayton, Victoria, Australia.
authors: M
authors: M
authors: Chen
authors: Melbourne School of Population and Global Health, University of Melbourne, Parkville, Victoria, Australia.
authors: J
authors: J
authors: Hocking
authors: Melbourne Sexual Health Centre, Carlton, Victoria, Australia.|Central Clinical School Monash University, Clayton, Victoria, Australia.
authors: C K
authors: CK
authors: Fairley
authors: Deakin Health Economics, Strategic Research Centre-Population Health Deakin University, Burwood, Victoria, Australia.
authors: R
authors: R
authors: Carter
authors: Deakin Health Economics, Strategic Research Centre-Population Health Deakin University, Burwood, Victoria, Australia.
authors: L
authors: L
authors: Bulfone
authors: Melbourne School of Population and Global Health, University of Melbourne, Parkville, Victoria, Australia.
authors: A
authors: A
authors: Hsueh
mesh_terms: D000293:Adolescent; D000328:Adult; D001315:Australia; D002690:Chlamydia Infections / Q000175:diagnosis / Q000191:economics*; D002692:Chlamydia trachomatis; D003362:Cost-Benefit Analysis; D042241:Early Diagnosis; D005260:Female; D006801:Humans; D018803:Models, Economic; D011247:Pregnancy; D011251:Pregnancy Complications, Infectious / Q000175:diagnosis / Q000191:economics*; D011296:Prenatal Diagnosis / Q000191:economics; D019057:Quality-Adjusted Life Years; D055815:Young Adult
keywords: Antenatal; chlamydia; cost-effectiveness; screening