Chlamydia screening for pregnant women aged 16-25 years attending an antenatal service: a cost-effectiveness study

Ong, J.J., Chen, M., Hocking, J., Fairley, C.K., Carter, R., Bulfone, L. and Hsueh, A. 2015, Chlamydia screening for pregnant women aged 16-25 years attending an antenatal service: a cost-effectiveness study, BJOG: an international journal of obstetrics and gynaecology, vol. 123, no. 7, pp. 1194-1202, doi: 10.1111/1471-0528.13567.

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Title Chlamydia screening for pregnant women aged 16-25 years attending an antenatal service: a cost-effectiveness study
Author(s) Ong, J.J.
Chen, M.
Hocking, J.
Fairley, C.K.
Carter, R.ORCID iD for Carter, R.
Bulfone, L.ORCID iD for Bulfone, L.
Hsueh, A.
Journal name BJOG: an international journal of obstetrics and gynaecology
Volume number 123
Issue number 7
Start page 1194
End page 1202
Total pages 9
Publisher Wiley
Place of publication Chichester, Eng.
Publication date 2015-08-26
ISSN 1471-0528
Keyword(s) Antenatal
Summary OBJECTIVE: Determine the cost-effectiveness of screening all pregnant women aged 16-25 years for chlamydia compared with selective screening or no screening. DESIGN: Cost effectiveness based on a decision model. SETTING: Antenatal clinics in Australia. SAMPLE: 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. MAIN OUTCOME MEASURES: 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. CONCLUSION: 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. TWEETABLE ABSTRACT: Chlamydia screening for all pregnant women aged 16-25 years during an antenatal visit is cost effective.
Language eng
DOI 10.1111/1471-0528.13567
Field of Research 140208 Health Economics
Socio Economic Objective 920507 Women's Health
HERDC Research category C1 Refereed article in a scholarly journal
Copyright notice ©2015, Wiley
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Document type: Journal Article
Collections: Faculty of Health
Population Health
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