PT - JOURNAL ARTICLE AU - Paddy Gillespie AU - Ciaran O'Neill AU - Elisabeth Adams AU - Katherine Turner AU - Diarmuid O'Donovan AU - Ruairi Brugha AU - Deirdre Vaughan AU - Emer O'Connell AU - Martin Cormican AU - Myles Balfe AU - Claire Coleman AU - Margaret Fitzgerald AU - Catherine Fleming TI - The cost and cost-effectiveness of opportunistic screening for <em>Chlamydia trachomatis</em> in Ireland AID - 10.1136/sextrans-2011-050067 DP - 2012 Apr 01 TA - Sexually Transmitted Infections PG - 222--228 VI - 88 IP - 3 4099 - http://sti.bmj.com/content/88/3/222.short 4100 - http://sti.bmj.com/content/88/3/222.full SO - Sex Transm Infect2012 Apr 01; 88 AB - Objective The objective of this study was to estimate the cost and cost-effectiveness of opportunistic screening for Chlamydia trachomatis in Ireland.Methods Prospective cost analysis of an opportunistic screening programme delivered jointly in three types of healthcare facility in Ireland. Incremental cost-effectiveness analysis was performed using an existing dynamic modelling framework to compare screening to a control of no organised screening. A healthcare provider perspective was adopted with respect to costs and included the costs of screening and the costs of complications arising from untreated infection. Two outcome measures were examined: major outcomes averted, comprising cases of pelvic inflammatory disease, ectopic pregnancy and tubal factor infertility in women, neonatal conjunctivitis and pneumonia, and epididymitis in men; and quality-adjusted life-years (QALY) gained. Uncertainty was explored using sensitivity analyses and cost-effectiveness acceptability curves.Results The average cost per component of screening was estimated at €26 per offer, €66 per negative case, €152 per positive case and €74 per partner notified and treated. The modelled screening scenario was projected to be more effective and more costly than the control strategy. The incremental cost per major outcomes averted was €6093, and the incremental cost per QALY gained was €94 717. For cost-effectiveness threshold values of €45 000 per QALY gained and lower, the probability of the screening being cost effective was estimated at &lt;1%.Conclusions An opportunistic chlamydia screening programme, as modelled in this study, would be expensive to implement nationally and is unlikely to be judged cost effective by policy makers in Ireland.