The Cost of Medicaid Savings: The Potential Detrimental Public Health Impact of Neonatal Circumcision Defunding

Table 4

Projected additional male cases of HIV and additional direct medical costs^a.

	African; American; 𝑛=6399	White; 𝑛=5776	Other; 𝑛=2680	Total; 𝑛=14,855
Baseline prevention fraction (60%)^b
Additional HIV cases	48	2	5	55
Additional cost discounted to time of infection^c	$18,252,700	$739,100	$1,932,600	$20,924,400
Additional cost discounted to birth^d	$7,150,000	$294,600	$804,200	$8,248,800
Highest prevention fraction (80%)^b
Additional HIV cases	85	4	8	97
Additional cost discounted to time of infection^c	$31,942,200	$1,612,600	$2,989,000	$36,543,800
Additional cost discounted to birth^d	$12,512,400	$642,700	$1,206,300	$14,361,400
Lowest prevention fraction (39%)^b
Additional HIV cases	24	1	3	28
Additional cost discounted to time of infection^c	$9,126,300	$336,000	$966,300	$10,428,600
Additional cost discounted to birth^d	$3,575,000	$133,900	$402,100	$4,111,000

^aPer South Carolina Medicaid birth year cohort.
^bPrevention fraction (1-relative risk) of male circumcision for reducing HIV transmission through heterosexual contact.
^cUsing Schackman et al’s discounted lifetime HIV treatment cost of $303,100 (in $US2004) inflated to $US2010 for a lifetime treatment cost of $377,360.
^dTo allow for direct comparison to circumcision savings in the cohort birth year.