The cost effectiveness of azithromycin for Chlamydia trachomatis infections in women.

BACKGROUND AND OBJECTIVES Azithromycin, an approved single-dose therapy for cervical chlamydia infections, costs four times as much as doxycycline, the standard multidose theapy. GOAL OF THIS STUDY This study examined whether azithromycin is cost effective for treating cervical chlamydia infections. STUDY DESIGN Two diagnostic strategies were compared: 1) laboratory confirmation of chlamydia, and 2) presumptive diagnosis from the perspective of the healthcare system and the publicly funded clinic. RESULTS From the healthcare perspective, the cost per case of pelvic inflammatory disease prevented with azithromycin ranges from a savings of $3,502 for laboratory confirmation to a cost of $792 for presumptive diagnosis. From the publicly funded clinic perspective, the cost per case of pelvic inflammatory disease prevented ranges from $709 for lab-confirmed diagnosis to $3,969 for presumptive treatment. CONCLUSION For the healthcare system, azithromycin is a cost-effective alternative to doxycycline. However, the cost of azithromycin must decrease markedly for it to be less costly to the publicly funded clinic.