The PrePex Device Is Unlikely to Achieve Cost-Savings Compared to the Forceps-Guided Method in Male Circumcision Programs in Sub-Saharan Africa
The PrePex Device Is Unlikely to Achieve Cost-Savings Compared to the Forceps-Guided Method in Male Circumcision Programs in Sub-Saharan Africa
复制标题
DOI：
10.1371/journal.pone.0053380
复制
发表时间：
2013-01-21
期刊：
影响因子：
3.7
通讯作者：
Bailey, Robert C.
中科院分区：
文献类型：
--
作者：
Obiero, Walter;Young, Marisa R.;Bailey, Robert C.
背景：男性包皮环切术（MC）可将男性异性恋感染HIV的风险降低约60%。目前正在撒哈拉以南非洲的14个国家扩大MC的艾滋病毒预防方案。目前，在许多撒哈拉以南非洲国家，MC的标准手术技术是钳引导男性包皮环切术（FGMC）方法。PrePex男性包皮环切术（PMC）方法可以取代FGMC，并可能降低MC编程成本。我们比较了将PrePex器械引入MC程控的潜在成本与钳引导方法的成本。研究方法：数据来自肯尼亚的一个MC服务提供组织尼扬扎生殖健康协会（NRHS）和肯尼亚卫生部。分析基于2009年至2011年在肯尼亚西部四个地区进行的48，265例MC程序。数据已输入世卫组织/艾滋病规划署决策者方案规划工具。该工具评估了多媒体中心方案拟订的直接和间接费用。进行了各种敏感性分析。结果：不包括PrePex装置的费用或包茎/包皮过紧男性的转诊费用，PMC和FGMC的MC手术费用分别为44.54 - 49.02美元和54.52 - 55.29美元。结论：与钳引导方法相比，PrePex器械不太可能显著节省成本。MC程序员应针对男性包皮环切术最低包的其他方面，以提高成本效益。
Background: Male circumcision (MC) reduces the risk of heterosexual HIV acquisition in men by approximately 60%. MC programs for HIV prevention are currently being scaled-up in fourteen countries in sub-Saharan Africa. The current standard surgical technique for MC in many sub-Saharan African countries is the forceps-guided male circumcision (FGMC)method. The PrePex male circumcision (PMC) method could replace FGMC and potentially reduce MC programming costs. We compared the potential costs of introducing the PrePex device into MC programming to the cost of the forceps-guided method. Methods: Data were obtained from the Nyanza Reproductive Health Society (NRHS), an MC service delivery organization in Kenya, and from the Kenya Ministry of Health. Analyses are based on 48,265 MC procedures performed in four Districts in western Kenya from 2009 through 2011. Data were entered into the WHO/UNAIDS Decision Makers Program Planning Tool. The tool assesses direct and indirect costs of MC programming. Various sensitivity analyses were performed. Costs were discounted at an annual rate of 6% and are presented in United States Dollars.Results: Not including the costs of the PrePex device or referral costs for men with phimosis/tight foreskin, the costs of one MC surgery were $44.54-$49.02 and $54.52-$55.29 for PMC and FGMC, respectively.Conclusion: The PrePex device is unlikely to result in significant cost-savings in comparison to the forceps-guided method. MC programmers should target other aspects of the male circumcision minimum package for improved cost efficiency.