An Economic Evaluation of a School-Based Sexually Transmitted Disease Screening Program

BACKGROUND: A school-based sexually transmitted disease (STD) screening program was implemented in eight New Orleans public high schools to detect chlamydia and gonorrhea. GOAL: The goal was to assess the incremental cost-effectiveness of replacing non-school-based screening with the school-based screening program. STUDY DESIGN: A decision-analysis model was constructed to compare costs and cases of expected pelvic inflammatory disease (PID) in the school-based screening scenario versus a non-school-based screening scenario. Cost-effectiveness was quantified and measured as cost per case of PID prevented. RESULTS: Under base-case assumptions, at an intervention cost of $86,449, the school screening program prevented an estimated 38 cases of PID, as well as $119,866 in treatment costs for PID and its sequelae, resulting in savings of $1524 per case of PID prevented. Results remained cost-saving over a reasonable range of model parameter estimates. CONCLUSIONS: The New Orleans school-based chlamydia screening program was cost-effective and cost-saving and could be cost-effective in other settings. School-based screening programs of this type are likely to be a cost-effective use of public funds and can reduce the burden of STDs among adolescents.