METHOTREXATE PROVIDES SIGNIFICANT COST SAVINGS FOR THE TREATMENT OF UNRUPTURED ECTOPIC PREGNANCY

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.