Document Detail


Expectant, medical or surgical treatment for spontaneous abortion in first trimester of pregnancy: a cost analysis.
MedLine Citation:
PMID:  15979988     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Misoprostol and expectant care have been shown to be acceptable alternatives to routine surgical evacuation for treatment of spontaneous abortion in the first trimester of pregnancy. The objective of this study was to analyse the cost of expectant care, misoprostol therapy and surgical evacuation. METHODS: A decision tree was designed to simulate the clinical outcome and health care resource utilization of surgical evacuation, misoprostol and expectant care for patients presenting with uncomplicated spontaneous abortion in the first trimester of pregnancy. Clinical inputs were estimated from literature and the cost analysis was conducted from the perspective of a public health care provider in Hong Kong. RESULTS: The base-case analysis showed that the misoprostol group (1000 US dollars per patient) was the least costly alternative, followed by the expectant care (1172 US dollars per patient) and surgical evacuation (2007 US dollars per patient). Rates of complete abortion using misoprostol and expectant care were identified as influential factors. Monte Carlo simulation (10000 cohorts) showed that the misoprostol and the expectant care groups were less costly than the surgical evacuation group 100 and 88% of the time. The misoprostol group was less costly than the expectant group 100% of the time. CONCLUSIONS: Misoprostol therapy appears to be the least costly approach for treatment of uncomplicated spontaneous abortion.
Authors:
Joyce H S You; Tony K H Chung
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't     Date:  2005-06-24
Journal Detail:
Title:  Human reproduction (Oxford, England)     Volume:  20     ISSN:  0268-1161     ISO Abbreviation:  Hum. Reprod.     Publication Date:  2005 Oct 
Date Detail:
Created Date:  2005-09-26     Completed Date:  2006-01-27     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  8701199     Medline TA:  Hum Reprod     Country:  England    
Other Details:
Languages:  eng     Pagination:  2873-8     Citation Subset:  IM    
Affiliation:
Centre for Pharmacoeconomics Research, School of Pharmacy, Department of Obstetrics & Gynaecology, Faculty of Medicine, The Chinese University of Hong Kong, Shatin, NT. joyceyou@cuhk.edu.hk
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MeSH Terms
Descriptor/Qualifier:
Abortifacient Agents, Nonsteroidal / economics,  pharmacology
Abortion, Spontaneous / therapy*
Cost-Benefit Analysis
Costs and Cost Analysis
Decision Trees
Dilatation and Curettage / economics
Female
Health Expenditures
Humans
Misoprostol / economics,  pharmacology
Monte Carlo Method
Pregnancy
Pregnancy Trimester, First
Sensitivity and Specificity
Time Factors
Treatment Outcome
Chemical
Reg. No./Substance:
0/Abortifacient Agents, Nonsteroidal; 59122-46-2/Misoprostol

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


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