E-screening for sexually transmissible infections and blood-borne viruses in New South Wales, Australia: a cost analysis.

Clinical Snapshot

Key Findings

• P Value: Not reported

• Effect Size: MyCheck A$137 vs Xpress A$146 per patient (A$9 difference favouring MyCheck)

• Primary Outcome: Total societal cost per patient screened

• Nnt Or Sensitivity: Annual savings of A$104,260 at Sydney Sexual Health Centre, projected A$419,077 statewide

• Confidence Interval: Not reported

Clinical Application

Requires telehealth infrastructure and off-site pathology collection arrangements, feasible in urban Australian settings Directly relevant to Australian sexual health services; supports PBS telehealth initiatives and aligns with National STI Strategy goals for improved access Patients seeking STI/HIV screening in Australian sexual health services, particularly suitable for MSM and transgender/gender diverse populations

Abstract

BACKGROUND: MyCheck is an e-testing pathway, first implemented at Sydney Sexual Health Centre, which enhances access to STI/HIV testing via telehealth and off-site sample collection; thus, reducing clinic visits. This study evaluates MyCheck's direct and indirect costs versus standard in-person screening (Xpress). METHODS: A 12-month bottom-up cost analysis from a societal perspective compared MyCheck and Xpress. Direct medical (health system), direct non-medical (patient travel) and indirect non-medical (productivity) costs were calculated using retrospective Sydney Sexual Health Centre data. Costs included pathology, staff time, overheads, consumables, patient travel and forgone productivity. Statewide scale-up costs were estimated, with sensitivity analyses adjusting for inflation, minimum wage and an increase in the proportion of MyCheck users with productivity loss. RESULTS: From January to July 2023, Sydney Sexual Health Centre conducted 2548 screening episodes (45% MyCheck, 55% Xpress), with MyCheck attracting more men who have sex with men/transgender and gender diverse patients. MyCheck's shorter appointments (median 5 min vs Xpress's 15 min) led to lower staff costs (A$5 vs A$16). MyCheck had higher overall health system cost (A$127/patient) compared with Xpress (A$91/patient), mostly due to pathology costs. However, considering patient travel cost and productivity loss for Xpress, MyCheck's societal cost (A$137) was lower than Xpress (A$146), yielding A$104,260 annual savings. Statewide scale-up provides significant societal savings (A$419,077/year). CONCLUSION: This analysis of MyCheck's direct and indirect costs compared with traditional in-person screening demonstrates significant societal savings, despite higher direct pathology costs. It underscores the importance of a broader societal perspective in cost analyses. Lowering private pathology costs could further enhance MyCheck's cost-effectiveness. MyCheck, an innovative e-screening pathway, reduces barriers for STI/blood-borne virus screening by improving patient convenience and reduced opportunity costs. Despite higher direct pathology costs, its societal cost savings support statewide scale-up for improved screening accessibility.

References

1. 1.Wong, A., Turner, F., Houghton, R., Varma, R., Aung, H. L., Menon, A., Bell, C., & Watts, C. (2026). E-screening for sexually transmissible infections and blood-borne viruses in New South Wales, Australia: a cost analysis. Sexual Health. https://doi.org/10.1071/SH25107