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Published on: November 30, 2010
A cost-utility analysis of neonatal circumcision
1Department of Pediatrics, Michigan State University College of Human Medicine, Marquette, Michigan, USA. vanhowe@lushen.com
Summary
Neonatal circumcision is not cost-effective, increasing costs and well-years lost. Even if free and complication-free, it remains more expensive than not circumcising, making it poor health policy.
Area of Science:
- Health Economics
- Medical Ethics
- Public Health Policy
Background:
- Neonatal circumcision is a common procedure with ongoing debate regarding its medical necessity and cost-effectiveness.
- Previous analyses have not comprehensively evaluated the long-term economic and health utility impacts from a societal perspective.
Purpose of the Study:
- To conduct a cost-utility analysis comparing neonatal circumcision with no circumcision.
- To determine the financial and health outcome implications of neonatal circumcision from a societal viewpoint.
Main Methods:
- Utilized published data from multiple observational studies.
- Employed a Markov analysis and the Quality of Well-being Scale.
- Adopted the standard reference case and a societal perspective for the cost-utility analysis.
Main Results:
- Neonatal circumcision resulted in an incremental cost of $828.42 per patient.
- An incremental 15.30 well-years were lost per 1000 males undergoing neonatal circumcision.
- Sensitivity analyses could not identify conditions under which neonatal circumcision became cost-effective.
Conclusions:
- Neonatal circumcision is not financially justifiable as a medical procedure.
- The procedure represents unfavorable health policy due to increased costs and reduced health utility.
- Medical support for neonatal circumcision lacks a sound financial or medical basis.
