Costs and Effectiveness of Neonatal Male Circumcision

Kacker, Seema; Frick, Kevin D.; Gaydos, Charlotte A.; Tobian, Aaron A.R.

doi:10.1001/archpediatrics.2012.1440

Cited by 49 publications

(50 citation statements)

References 64 publications

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“…In a contradictory study, by Van Howe, a cost utility analysis did not show circumcision to be cost effective on sensitivity analysis and on Monte Carlo simulation [222]. A recent study analyzed the impact of a reducing circumcision rate in the US on cost implications related to STI's and UTI [223]. Reducing circumcision rates from 79% to 10% would increase lifetime direct medical costs by 313$ per foregone circumcision procedure in males.…”

Section: Cost Analyses Of Neonatal Circumcisionmentioning

confidence: 99%

CUA guideline on the care of the normal foreskin and neonatal circumcision in Canadian infants

Davé

Afshar

Braga

et al. 2017

CUAJ

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Section: Cost Analyses Of Neonatal Circumcisionmentioning

confidence: 99%

CUA guideline on the care of the normal foreskin and neonatal circumcision in Canadian infants

Davé

Afshar

Braga

et al. 2017

CUAJ

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“…An old cost analysis that concluded cost–benefit was neutral,56 did not consider all the benefits 57. More recently, a cost analysis of outcomes including STIs and UTIs found that IMC is cost saving, in the amount of US$4.4 billion for 10 annual birth cohorts 58. The AAP did cite a study by the CDC that found IMC to be cost saving for HIV prevention in the USA 59.…”

Section: Are There ‘Logical Leaps’ In the Aap's Statement?mentioning

confidence: 99%

“…S&VH ignore calculations showing that if IMC rates were to decrease to 10%, the resulting increase in infant UTIs would lead to an additional US$32 million in direct medical treatment costs for each annual birth cohort in the USA,58 demonstrating a portion of the considerable lifetime cost savings conferred by IMC.…”

Section: Protection Against Utismentioning

confidence: 99%

Veracity and rhetoric in paediatric medicine: a critique of Svoboda and Van Howe's response to the AAP policy on infant male circumcision

et al. 2013

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In a recent issue of the Journal of Medical Ethics,Svoboda and Van Howe commented on the 2012 changein the American Academy of Pediatrics (AAP) policy on newborn male circumcision, in which the AAP stated that benefits of the procedure outweigh the risks. Svoboda and Van Howe disagree with the AAP conclusions. We show here that their arguments against male circumcision are based on a poor understanding of epidemiology,erroneous interpretation of the evidence, selective citation of the literature, statistical manipulation of data, and circular reasoning. In reality, the scientific evidence indicates that male circumcision, especially when performed in the newborn period, is an ethically and medically sound low-risk preventive health procedure conferring a lifetime of benefits to health and well-being.Policies in support of parent-approved elective newborn circumcision should be embraced by the medical,scientific and wider communities.

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“…12 Circumcision provides the greatest health benefits and is most cost-effective when the procedure isperformed asa neonate (#28 days). 2,13 Neonatal circumcision has a low rate of complications, is inexpensive, and is usually performed in the newborn nursery by using local anesthesia. In contrast, postneonatal circumcision (performed at .28 days) has a higher complication rate, and often includes general anesthesia, which increases the risk and cost of the procedure.…”

mentioning

confidence: 99%

Circumcision of Privately Insured Males Aged 0 to 18 Years in the United States

et al. 2014

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WHAT'S KNOWN ON THIS SUBJECT: Neonatal circumcision in the United States has been estimated to be performed in ∼58% of all neonates, and varies by US geographic region. WHAT THIS STUDY ADDS:This study estimates neonatal and postneonatal circumcision rates among commercially insured males aged 0 to 18 years that were performed in both inpatient and outpatient settings. This study also estimates indications and payments for the procedure. abstract BACKGROUND: Male circumcision confers protection against HIV, sexually transmitted infections, and urinary tract infections. Compared with circumcision of postneonates (.28 days), circumcision of neonates is associated with fewer complications and usually performed with local rather than general anesthesia. We assessed circumcision of commercially insured males during the neonatal or postneonatal period. METHODS:We analyzed 2010 MarketScan claims data from commercial health plans, using procedural codes to identify circumcisions performed on males aged 0 to 18 years, and diagnostic codes to assess clinical indications for the procedure. Among circumcisions performed in the first year of life, we estimated rates for neonates and postneonates. We estimated the percentage of circumcisions by age among males who had circumcisions in 2010, and the mean payment for neonatal and postneonatal procedures. RESULTS:We found that 156 247 circumcisions were performed, with 146 213 (93.6%) in neonates and 10 034 (6.4%) in postneonates. The neonatal circumcision rate was 65.7%, and 6.1% of uncircumcised neonates were circumcised by their first birthday. Among postneonatal circumcisions, 46.6% were performed in males younger than 1 year and 25.1% were for nonmedical indications. The mean payment was $285 for a neonatal and $1885 for a postneonatal circumcision. CONCLUSIONS:The large number of nonmedical postneonatal circumcisions suggests that neonatal circumcision might be a missed opportunity for these boys. Delay of nonmedical circumcision results in greater risk for the child, and a more costly procedure. Discussions with parents early in pregnancy might help them make an informed decision about circumcision of their child. Pediatrics 2014;134:950-956

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Costs and Effectiveness of Neonatal Male Circumcision

Cited by 49 publications

References 64 publications

CUA guideline on the care of the normal foreskin and neonatal circumcision in Canadian infants

CUA guideline on the care of the normal foreskin and neonatal circumcision in Canadian infants

Veracity and rhetoric in paediatric medicine: a critique of Svoboda and Van Howe's response to the AAP policy on infant male circumcision

Circumcision of Privately Insured Males Aged 0 to 18 Years in the United States

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