The West Midlands Health Technology Assessment Collaboration, Department of Public Health, Epidemiology & Biostatistics, University of Birmingham, Birmingham, United Kingdom.
PLoS One. 2010 Mar 10;5(3):e9628. doi: 10.1371/journal.pone.0009628.
There is conclusive evidence from observational data and three randomized controlled trials that circumcised men have a significantly lower risk of becoming infected with the human immunodeficiency virus (HIV). The aim of this study was to systematically review economic evaluations on adult male circumcision (AMC) for prevention of heterosexual acquisition of HIV in men.
Studies were identified from the following bibliographic databases: MEDLINE (Ovid), EMBASE (Ovid), Cochrane Library (Wiley's internet version), NHS EED and DARE Office of Health Economics HEED. The searches were conducted in November 2009. The Drummond 10-point checklist was used for methodological critique of the economic evaluations. Cost data were inflated and converted to 2008 US dollars (US$). Of 264 identified papers, only five met the inclusion criteria and were included in the review. The studies were published between 2006 and 2009. Most of the studies were carried out from the perspective of government healthcare payer. The time horizon ranged from 10 to 20 years. All studies reported that AMC is cost-effective. The reported cost per HIV infection averted ranged from US$174 to US$2808. The key driver of the cost-effectiveness models was circumcision efficacy.
All published economic evaluations offered the same conclusion that AMC is cost-effective and potentially cost-saving for prevention of heterosexual acquisition of HIV in men. On these grounds, AMC may be seen as a promising new form of strategy for prevention of HIV and should be implemented in conjunction with other evidence-based prevention methods.
从观察性数据和三项随机对照试验中都有确凿的证据表明，行包皮环切术的男性感染人类免疫缺陷病毒（HIV）的风险显著降低。本研究旨在系统地综述成人男性包皮环切术（AMC）预防男性异性恋人群中 HIV 感染的经济学评价。
我们从以下文献数据库中检索到研究：MEDLINE（Ovid）、EMBASE（Ovid）、Cochrane 图书馆（Wiley 的互联网版本）、NHS EED 和 DARE 卫生经济学办公室的 HEED。检索于 2009 年 11 月进行。采用 Drummond 10 分制检查表对经济学评价的方法学进行了评价。成本数据经过通胀调整并转换为 2008 年的美元（US$）。在 264 篇确定的论文中，仅有 5 篇符合纳入标准，被纳入本综述。这些研究的发表时间在 2006 年至 2009 年之间。大多数研究是从政府医疗保健支付方的角度进行的。时间范围从 10 年到 20 年不等。所有研究均报告称 AMC 具有成本效益。报告的每例 HIV 感染避免的成本为 174 美元至 2808 美元。成本效益模型的关键驱动因素是包皮环切术的效果。
所有已发表的经济学评价都得出了相同的结论，即 AMC 对预防男性异性恋人群中 HIV 的感染具有成本效益，并且可能具有成本节约效果。基于这些理由，AMC 可能被视为预防 HIV 的一种有前途的新策略，应与其他基于证据的预防方法一起实施。
