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Medical Decision Making, Vol. 24, No. 6, 584-601 (2004)
DOI: 10.1177/0272989X04271039
© 2004 Society for Medical Decision Making

A Cost-Utility Analysis of Neonatal Circumcision

Robert S. Van Howe, MD, MS, FAAP

Department of Pediatrics, Michigan State University College of Human Medicine, Marquette, Michigan

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.

Key Words: circumcision • phimosis • cost-utility analysis • circumcision complications • penile cancer


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