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The PrePex Device Is Unlikely to Achieve Cost-Savings Compared to the Forceps-Guided Method in Male Circumcision Programs in Sub-Saharan Africa

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  • Walter Obiero
  • Marisa R Young
  • Robert C Bailey

Abstract

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.

Suggested Citation

  • Walter Obiero & Marisa R Young & Robert C Bailey, 2013. "The PrePex Device Is Unlikely to Achieve Cost-Savings Compared to the Forceps-Guided Method in Male Circumcision Programs in Sub-Saharan Africa," PLOS ONE, Public Library of Science, vol. 8(1), pages 1-6, January.
  • Handle: RePEc:plo:pone00:0053380
    DOI: 10.1371/journal.pone.0053380
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    References listed on IDEAS

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    1. Dianna Edgil & Petra Stankard & Steven Forsythe & Dino Rech & Kristin Chrouser & Tigistu Adamu & Sameer Sakallah & Anne Goldzier Thomas & Jennifer Albertini & David Stanton & Kim Eva Dickson & Emmanue, 2011. "Voluntary Medical Male Circumcision: Logistics, Commodities, and Waste Management Requirements for Scale-Up of Services," PLOS Medicine, Public Library of Science, vol. 8(11), pages 1-10, November.
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    Cited by:

    1. Emmanuel Njeuhmeli & Katharine Kripke & Karin Hatzold & Jason Reed & Dianna Edgil & Juan Jaramillo & Delivette Castor & Steven Forsythe & Sinokuthemba Xaba & Owen Mugurungi, 2014. "Cost Analysis of Integrating the PrePex Medical Device into a Voluntary Medical Male Circumcision Program in Zimbabwe," PLOS ONE, Public Library of Science, vol. 9(5), pages 1-7, May.
    2. Djesika D Amendah & George Mukamah & Albert Komba & Carolyne Ndila & Thomas N Williams, 2013. "Routine Paediatric Sickle Cell Disease (SCD) Outpatient Care in a Rural Kenyan Hospital: Utilization and Costs," PLOS ONE, Public Library of Science, vol. 8(4), pages 1-6, April.

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