Economic Outcomes of Disease Intervention Specialist-Delivered Interventions for Sexually Transmitted Infections: A Systematic Review.

Background: Although numerous studies have demonstrated the effectiveness of interventions delivered by disease intervention specialists (DIS), relatively few studies have assessed their economic outcomes. We performed a systematic literature review of the cost, cost-effectiveness, and cost-benefit of DIS-delivered interventions for sexually transmitted infections (STIs) in the United States.

Methods: Building on a recent systematic review of the effectiveness of DIS-delivered interventions, we reviewed economic outcomes associated with these interventions for STIs. We searched articles indexed in MEDLINE, Web of Science, CINAHL, and ProQuest from 2000 through December 2022, using these inclusion criteria: addressed an intervention of DIS-delivered interventions for STIs including partner services; United States setting; and included estimates for program cost, cost-effectiveness, or cost-benefit. Findings were summarized through narrative synthesis.

Results: Seven studies met the inclusion criteria. Overall, DIS-delivered interventions including STI partner services can be a cost-effective use of public health resources. In some scenarios, the cost of these interventions can be completely offset by averted medical costs. Cost and cost-effectiveness estimates of DIS-delivered interventions can vary across geographic settings and under different epidemiologic conditions.

Conclusions: Although scarce, the available evidence suggests DIS-delivered interventions including STI partner services are an efficient use of public health resources. Health economic modeling studies are needed to facilitate conversion of intermediate cost-effectiveness outcomes (e.g., cost per syphilis case identified and treated) into standard cost-effectiveness outcomes (e.g., cost per quality-adjusted life year [QALY] gained).