F. Robin et al., METHOTREXATE PROVIDES SIGNIFICANT COST SAVINGS FOR THE TREATMENT OF UNRUPTURED ECTOPIC PREGNANCY, Clinical drug investigation, 15(5), 1998, pp. 405-411
The aim of this study was to compare direct and indirect costs of sing
le-dose methotrexate and laparoscopy in the treatment of unruptured ec
topic pregnancy. We conducted a prospective study between 1 January 19
95 and 31 May 1997 and recorded costs accrued from outpatient and inpa
tient treatment with methotrexate (group I) and laparoscopy (group II)
. We used the French National Social Security nomenclature as referenc
e for the different costs. Indirect costs were estimated from national
demographic data. 39 patients were included in group I and 38 in grou
p II. Single-dose methotrexate was the most economic management of unr
uptured tubal pregnancy ($US1436 per case vs $US3170 per case for lapa
roscopy) since it reduced the total cost by approximately 50%. This wa
s due to a dramatic reduction in charges related to hospitalisation an
d the operating room. Indirect costs were also reduced, mainly as a re
sult of a shorter recovery time ($US237 vs $US475). However, there was
no further evidence of any cost effectiveness of methotrexate therapy
when hospitalisation was required. In conclusion, single-dose methotr
exate appeared to be the most economic approach for the treatment of u
nruptured ectopic pregnancy. Selection of cases is mandatory to guaran
tee a cost savings for the treatment of unruptured ectopic pregnancy.