Cost-benefit analysis of first-void urine Chlamydia trachomatis screening program

Objective: To perform a cost-benefit analysis of a Chlamydia trachomatis screening program based on first-void urine testing of asymptomatic women using a polymerase chain reaction (PCR) test. Methods: A decision tree was developed. Selected variables based on assumptions were subjected to sensitivity analyses to make the model accurate and defensible. Results: Screening for chlamydial infections using the PCR test was shown to be cost-effective even in low-prevalence populations. Compared with a symptom-driven no-screening situation, a universal C trachomatis screening program using the PCR test would save money, in terms of direct cost, when the baseline prevalence of C trachomatis infection exceeds 3.9%. Conclusion: Cost analyses are still rare among trials that compare pharmacologic or procedural health care interventions. Socioeconomic studies linking secondary prevention of C trachomatis infection and infertility and adverse pregnancy outcome are needed to convince public health authorities of the need for and the benefit of such programs. (Obstet Gynecol 1998;92:292-8. (C) 1998 by The American College of Obstetricians and Gynecologists.).