COST-BENEFIT-ANALYSIS OF FIRST-VOID URINE CHLAMYDIA-TRACHOMATIS SCREENING-PROGRAM

Objective: To perform a cost-benefit analysis of a Chlamydia trachomat is screening program based on first-void urine testing of asymptomatic women using a polymerase chain reaction (PCR) test. Methods: A decisi on tree was developed. Selected variables based on assumptions were su bjected to sensitivity analyses to make the model accurate and defensi ble. Results: Screening for chlamydial infections using the PCR test w as shown to be cost-effective even in low-prevalence populations. Comp ared with a symptom-driven no-screening situation, a universal C trach omatis screening program using the PCR test would save money, in terms of direct cost, when the baseline prevalence of C trachomatis infecti on exceeds 3.9%. Conclusion: Cost analyses are still rare among trials that compare pharmacologic or procedural health care interventions. S ocioeconomic studies linking secondary prevention of C trachomatis inf ection and infertility and adverse pregnancy outcome are needed to con vince public health authorities of the need for and the benefit of suc h programs. (Obstet Gynecol 1998;92:292-8. (C) 1998 by The American Co llege of Obstetricians and Gynecologists.).