The cost-effectiveness of accelerated partner therapy (APT) compared to standard contact tracing for people with chlamydia: an economic evaluation based on the LUSTRUM population-based chlamydia transmission model

ABSTRACT Objective To investigate the cost-effectiveness of accelerated partner therapy (APT) compared with standard contact tracing for people with sexually transmitted chlamydia infection in the United Kingdom Design Economic evaluation using a model consisting of two components: a population-based chlamydia transmission component, to estimate the impact of APT on chlamydia prevalence, and an economic component, to estimate the impact of APT on healthcare costs and health outcomes. Setting United Kingdom Participants Hypothetical heterosexual population of 50,000 men and 50,000 women aged 16-34 years. Main Outcome Measures Cost-effectiveness based on quality-adjusted life years (QALYs) gained and major outcomes averted (MOA), defined as mild pelvic inflammatory disease (PID), severe PID, chronic pelvic pain, ectopic pregnancy, tubal factor infertility and epididymitis. Results For a model population of 50,000 men and 50,000 women and an APT intervention lasting 5 years, the intervention cost of APT (£135,201) is greater than the intervention cost of standard contact tracing (£116,334). When the costs of complications arising from chlamydia are considered, the total cost of APT (£370,657) is lower than standard contact tracing (£379,597). Thus, APT yields a total cost saving of approximately £9000 and leads to 73 fewer major outcomes and 21 fewer QALYs lost. Hence, APT is the dominant PN strategy. APT remained cost-effective across the full range of sensitivity analyses. Conclusions Based on cost-effectiveness grounds APT is likely to be recommended as an alternative to standard contact tracing for chlamydia infection in the United Kingdom