Pregnancy: A comparison of methotrexate versus laparoscopic surgery for the treatment of ectopic pregnancy: a cost analysis

This study was a cost analysis of direct medical costs of themethotrexate management versus laparoscopic surgery in the treatmentof ectopic pregnancy. A total of 40 patients treated from January1991 to October 1994 with methotrexate were compared with another40 patients treated at the same hospital by laparoscopy fromApril 1986 to June 1994. Medical records for all these patientswere received and hospital databases were used to retrieve informationon cost Treatment cost included the primary treatment, hospitalizationand outpatient follow-up necessitated by treatment, complicationsand secondary treatment in cases of treatment failure. The costrelated to diagnosis was excluded. The direct medical costsfor methotrexate and laparoscopy groups were based on successrates of 72.5 and 95% respectively. The total cost of methotrexatetreatment was Canadian $35 180 compared with Canadian $73 440for the laparoscopic treatment. The mean ± SE cost perpatient was Canadian $880 ± 160 in the methotrexate groupcompared with Canadian $1840 ± 150 in the laparoscopicgroup (P 0.001). The mean ± SE cost per patient withmethotrexate success was Canadian $330 ± 67 comparedwith Canadian $2330 ± 220 per patient with methotrexatefailure (P = 0.001). A complete assessment of methotrexate treatment,including cost-benefit and cost-effectiveness, is warranted.