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Is Accelerated Partner Therapy (APT) a cost-effective alternative to routine patient referral partner notification in the UK? Preliminary cost–consequence analysis of an exploratory trial
  1. Tracy E Roberts1,
  2. Angelos Tsourapas1,
  3. Lorna Sutcliffe2,
  4. Jackie Cassell3,
  5. Claudia Estcourt2,4
  1. 1Health Economics Unit, School of Health and Population Sciences, University of Birmingham, Birmingham, UK
  2. 2Centre for Infectious Diseases: Sexual Health and HIV, Barts and The London School of Medicine and Dentistry, London, UK
  3. 3Division of Primary Care and Public Health, Brighton and Sussex Medical School, Brighton, UK
  4. 4Barts and the London NHS Trust, London, UK
  1. Correspondence to Professor Tracy Roberts, Professor of Health Economics, Health Economics Unit, University of Birmingham, Edgbaston, Birmingham B15 2TT, UK; t.e.roberts{at}bham.ac.uk

Abstract

Objectives To undertake a cost–consequence analysis to assess two new models of partner notification (PN), known as Accelerated Partner Therapy (APT Hotline and APT Pharmacy), as compared with routine patient referral PN, for sex partners of people with chlamydia, gonorrhoea and non-gonococcal urethritis.

Methods Comparison of costs and outcomes alongside an exploratory trial involving two genitourinary medicine clinics and six community pharmacies. Index patients selected the PN method (APT Hotline, APT Pharmacy or routine PN) for their partners. Clinics and pharmacies recorded cost and resource use data including duration of consultation and uptake of treatment pack. Cost data were collected prospectively for two out of three interventions, and data were synthesised and compared in terms of effectiveness and costs.

Results Routine PN had the lowest average cost per partner treated (approximately £46) compared with either APT Hotline (approximately £54) or APT Pharmacy (approximately £53) strategies. The cost–consequence analysis revealed that APT strategies were more costly but also more effective at treating partners compared to routine PN.

Conclusion The hotline strategy costs more than both the alternative PN strategies. If we accept that strategies which identify and treat partners the fastest are likely to be the most effective in reducing reinfection and onward transmission, then APT Hotline appears an effective PN strategy by treating the highest number of partners in the shortest duration. Whether the additional benefit is worth the additional cost cannot be determined in this preliminary analysis. These data will be useful for informing development of future randomised controlled trials of APT.

  • Accelerated partner therapy
  • cost–onsequence analysis
  • sexually transmitted infection
  • partner notification
  • exploratory trial
  • chlamydia trachomatis
  • neisseria gonorrhoeae
  • non-gonococcal urethritis
  • economic analysis
  • chlamydia infection
  • reproductive health
  • sociology
  • opportunistic infection
  • heterosexual behaviour
  • gum services
  • risk profiles
  • service development

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Footnotes

  • Competing interests None.

  • Ethics approval Ethics approval was provided by Norfolk Research Ethics Committee, REC: 06/Q0101/3. This relates to the main study. Ethical approval was not required for the health economics work described here.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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