Document Detail


Direct cost of single dose methotrexate for unruptured ectopic pregnancy. Prospective comparison with laparoscopy.
MedLine Citation:
PMID:  10659909     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
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.
Authors:
F Lecuru; F Robin; S Chasset; F Leonard; S Guitti; R Taurelle
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Publication Detail:
Type:  Clinical Trial; Comparative Study; Journal Article    
Journal Detail:
Title:  European journal of obstetrics, gynecology, and reproductive biology     Volume:  88     ISSN:  0301-2115     ISO Abbreviation:  Eur. J. Obstet. Gynecol. Reprod. Biol.     Publication Date:  2000 Jan 
Date Detail:
Created Date:  2000-02-29     Completed Date:  2000-02-29     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  0375672     Medline TA:  Eur J Obstet Gynecol Reprod Biol     Country:  IRELAND    
Other Details:
Languages:  eng     Pagination:  1-6     Citation Subset:  IM    
Affiliation:
Service de Gynécologie-Obstétrique, Hôpital Boucicaut, Paris, France. fabrice.lecuru@bcc.ap-hop-paris.fr
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MeSH Terms
Descriptor/Qualifier:
Abortifacient Agents, Nonsteroidal / administration & dosage,  economics*
Adult
Cost Savings
Female
Hospital Costs
Humans
Laparoscopy / economics*
Length of Stay / economics
Methotrexate / administration & dosage,  economics*
Pregnancy
Pregnancy, Ectopic / drug therapy*,  economics,  surgery*
Prospective Studies
Chemical
Reg. No./Substance:
0/Abortifacient Agents, Nonsteroidal; 59-05-2/Methotrexate

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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