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The Pediatric Forum
Comparative Effectiveness Research
February 2013

Costs and Benefits of Male Circumcision

Author Affiliations

Author Affiliations: Department of Clinical Pharmacy, Pharmaceutical Economics, and Policy and Leonard Schaeffer Center for Health Policy and Economics, University of Southern California, University Park Campus, Los Angeles.

JAMA Pediatr. 2013;167(2):198. doi:10.1001/jamapediatrics.2013.829

Kacker et al1 present an economic model to justify Medicaid covering newborn male circumcision (MC) in the United States. However, their model uses highly flawed assumptions and projections. About 79% of their savings are MC-attributed reductions in human immunodeficiency virus (HIV) sexual transmission (only beginning about 12 years after enhanced MC coverage), but their base case lifetime cost of treating HIV/AIDS ($388 754) derives from estimates with highly active antiretroviral therapy (HAART) using brand name prices. In 12 years, most of these HAART medications will be generic.

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