OBJECTIVES: Chlamydia is the most common bacterial sexually transmitted infection worldwide. When diagnosed it is routinely treated with antibiotics, but most infections are asymptomatic. Untreated infections, even if asymptomatic, can result in serious reproductive pathologies: pelvic inflammatory disease, ectopic pregnancy, and infertility, in women. This study aimed to review the economic burden and quality of life (QoL) impact of chlamydia in USA and Europe big five countries (EU5).

METHODS: A targeted literature review was conducted in PubMed and Embase to identify published data on economic burden of chlamydia in USA and EU5, targeting publications since 2010. Extracted study data included associated costs (direct and indirect), modeled health care resource utilization, and QoL. Data gaps were analyzed at the regional level.

RESULTS: 81 studies were identified with insights on chlamydia costs, and 11 on QoL. The most common topic was economic evaluation of screening programs, deemed to be cost-effective in most cases. Incidence of chlamydia is high (4 million annual cases in USA), with burden highly concentrated in women: e.g., per averaged incident case, CDC reported lifelong medical costs of USD 46 and USD 262, concomitant with 0.00094 and 0.04698 QALYs lost, for men and women respectively. Both costs and QALYs were driven by sequelae, but there is substantial variation in these estimates across the literature. Data available on productivity losses due to complications are very limited. Few studies showed that chlamydia sequelae impair QoL in both men and women, but documentation is scarce. There is a lack of specific QoL PROs for chlamydia.

CONCLUSIONS: Economic burden and QoL impact of chlamydia are not extensively documented but seems to be mainly driven by its complications which disproportionately affect young women in the USA and EU5. Evidence gaps need to be addressed to improve the prevention of chlamydia complications.