A cost-utility analysis of neonatal circumcision.
A cost-utility analysis, based on published data from multiple observational studies, comparing boys circumcised at birth and those not circumcised was undertaken using the Quality of Well-being Scale, a Markov analysis, the standard reference case, and a societal perspective. Neonatal circumcision increased incremental costs by $828.42 per patient and resulted in an incremental 15.30 well-years lost per 1000 males. If neonatal circumcision was cost-free, pain-free, and had no immediate complications, it was still more costly than not circumcising. Using sensitivity analysis, it was impossible to arrange a scenario that made neonatal circumcision cost-effective. Neonatal circumcision is not good health policy, and support for it as a medical procedure cannot be justified financially or medically.
Van Howe
Robert S
RS
Department of Pediatrics, Michigan State University College of Human Medicine, Marquette, Michigan, USA. vanhowe@lushen.com
D002944:Circumcision, Male / Q000009:adverse effects / Q000191:economics*; D003362:Cost-Benefit Analysis; D006760:Hospitalization / Q000191:economics; D006801:Humans; D007231:Infant, Newborn; D008297:Male; D008390:Markov Chains; D011183:Postoperative Complications / Q000191:economics / Q000209:etiology