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Vaccines for the 21st Century A Tool for Decisionmaking (2000) / Chapter Skim
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Appendix 2: Chlamydia
Pages 149-158

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From page 149...
... The committee estimated that there are 130,000 cases annually of chlamydia infections in infants. There is very minimal mortality associated with this infection; the committee has indicated a nominal number of 5 deaths in women annually for purposes of modeling.
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From page 150...
... Cases <1 1,933,000 0.00 0 1 - 7,905,000 126.50 10,000 5-14 18,554,000 485.07 90,000 15-24 17,747,000 6,761.71 1,200,000 25-34 20,835,000 2,879.77 600,000 35~4 21,238,000 329.60 70,000 45-54 15,447,000 129.47 20,000 55~4 11,140,000 89.77 10,000 65-74 10,544,000 0.00 0 75-84 6,814,000 0.00 0 85+ 2,593,000 0.00 0 Total 134 750,000 1,484.23 2,000,000 Health consequences of chlamydia infection in women accounted for in the model include acute urethral syndrome, mild cervicitis, pelvic inflammatory disease (PID) and its sequelae (ectopic pregnancy, chronic pelvic pain, and infertility, assumed for calculation purposes to incur costs and decreased health states with a S-year lag from infection)
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From page 151...
... inpatient treatment Chronic pelvic pain 59,400 3.0% PID sequelae: 5-year lag 0.60 22.7313 (duration remaining lifetime) Infertility 66,000 3.3% PID sequelae: 5-year lag 0.82 22.7313 (duration remaining lifetime)
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From page 152...
... cases with a much more serious decrement in health status for longer periods of time. Examples include ectopic pregnancy (14,850 cases treated as an inpatient for 3 days and 4 weeks recuperation as an outpatient at an HUI of .66)
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From page 153...
... treated as an outpatient only incur costs associated with a limited physician visit, a specialist physician visit, a mid-level diagnostic, and an inexpensive prescription medication. More severe cases of PID requiring hospitalization are associated with hospitalization costs, specialist in-patient physician visits, and a mid-level diagnostic.
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From page 154...
... outpatient laparoscopy 50% $1,250 1 laparoscopy 50% $300 2 surgeon 50% $500 2 anesthesiologist 50% $100 1 diagnostics b 50% $100 1 physician b Ectopic Pregnancy Inpatient PID sequelae: 5-year lag inpatient 100% $3,000 1 hospitalization 100% $150 1 physician c 100% $100 1 diagnostics b 100% $500 1 surgeon 100% $500 1 anesthesiology outpatient after inpatient 100% $100 2 physician b
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From page 155...
... Infertility PID sequelae: 5-year lag treatment assumed to occur 5 years after onset of infection 50% $150 6 physician c 50% $500 1 diagnostic c 38% $1,000 38% $500 38% $150 2 outpatient laparoscopy hospitalization surgeon/anesthesiologist .
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From page 156...
... inpatient 100% $150 1 comprehensive 100% $100 1 intermediate 100% $50 2 brief 100% $50 1 diagnostic 100% $50 1 medication b and prescription medications. Inpatient costs for the smaller number of infants with pneumonia requiring hospitalization include hospitalization costs, physician visits (specialists and general)
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From page 157...
... Although the number of new Chlamydia infections in men equal those in women in this model, the number of QALYs lost due to disease in men is much less due to the decreased severity of the disease experienced in men. If a vaccine program for Chlamydia were implemented today and the vaccine was 100% efficacious and utilized by 100% of the target population, the annualized present value of the health care costs saved would be $850 million.
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From page 158...
... A negative value represents a saving in costs in addition to a saving in QALYs. Using committee assumptions of less-than-ideal utilization and including time and monetary costs until a vaccine program is implemented, the annualized present value of the cost per QALY gained is $200.
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Key Terms

  • committee estimated
  • chlamydia infections
  • costs incurred
  • physician visit
  • acute urethral

  • committee assumptions
  • chronic pelvic
  • pelvic pain
  • using committee
  • ectopic pregnancy

  • prescription medication
  • monetary costs
  • urethral syndrome
  • inpatient costs
  • target population

  • including time
  • physician visits
  • inexpensive prescription
  • limited physician
  • inexpensive diagnostic

  • outpatient laparoscopy
  • care costs
  • chlamydia trachomatis
  • outpatient costs
  • incur costs

  • mortality weekly
  • weekly report
  • health utility
  • utility index
  • age distribution


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