OBJECTIVE: In order to increase case-detection of Chlamydia trachomatis (CT) in a multicultural, low-income and high-CT-prevalence neighbourhood a novel approach was piloted in collaboration with the pharmacy of the health centre. The objective of this study is to estimate cost-effectiveness of the approach. METHODS: During a two year period, women aged 15-29yrs. who collected their contraceptives at the pharmacy were offered CT-test materials. Home-collected urine could be mailed to the laboratory and the General Practitioner received the results. RESULTS: Nine percent of respondents were CT-positive (14% among 15-24 yr). There was a strong association with Surinamese/Antillean background. Uptake of the programme was low (27%). Net cost per PID prevented ranged from cost-saving up to €3872 in a low complication rate scenario. CONCLUSIONS: Faced with higher risk, but low participation rates, active case-detection of CT-infections in "high-prevalence-area's" needs a concerted approach of different providers and community organisations, both in secondary as in primary prevention. The pharmacist can contribute if proper liaison is made with primary care providers and/or public health services for (partner-)treatment, counseling, and comprehensive sexual health care.