Abstract
Objectives: to compare the direct cost of single dose methotrexate (MTX) and laparoscopy in the
treatment of unruptured ectopic pregnancy (unruptured EP). Study design: A prospective nonrandomized study. Thirty-two women received intramuscular MTX (1
mg/kg) on an out-patient basis when they fulfilled the following requirements: human
chorionic gonadotropin (hCG) level <5000 IU/l, hematosalpinx diameter <3 cm and peritoneal
fluid <100 cc. Follow-up consisted of clinical controls and hCG assays. Twenty-seven
women eligible for MTX therapy according to the above conditions underwent laparoscopic
salpingectomy because some of them refused the therapy while others had contraindications
to MTX. We recorded all the medical expenses related to the out-patient and in-patient
management for the two treatment options. The cost was calculated according to the
French General Nomenclature of Professional Acts and expressed in Euros. Results: MTX resulted in a significantly lower mean direct cost in comparison with surgery
(E 1145 vs. 2442, P=0.006) that was mainly due to shortened hospital stay (1.1 vs. 2.8 days, P=0.007). Conversely MTX required a significantly higher number of medical acts during
the follow-up. Costs for MTX therapy were closely related to the length of hospitalization
and to the duration of the follow-up. Conclusion: Single dose MTX provides significant cost-savings when compared to laparoscopy. Savings
reach a peak for small unruptured EP because hospitalization is not required and the
length of follow-up reduced.
Keywords
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Article info
Publication history
Accepted:
April 21,
1999
Received:
January 16,
1999
Identification
Copyright
© 2000 Elsevier Science Ireland Ltd. Published by Elsevier Inc. All rights reserved.
