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 single-dose methotrexate and laparoscopy in the treatment of unruptured ectopic pregnancy. We conducted a prospective study between 1 January 1995 and 31 May 1997 and recorded costs accrued from outpatient and inpatient treatment with methotrexate (group I) and laparoscopy (group II). We used the French National Social Security nomenclature as reference for the different costs. Indirect costs were estimated from national demographic data. 39 patients were included in group I and 38 in group II. Single-dose methotrexate was the most economic management of unruptured tubal pregnancy ($US1436 per case vs $US3170 per case for laparoscopy) since it reduced the total cost by approximately 50%. This was due to a dramatic reduction in charges related to hospitalisation and the operating room. Indirect costs were also reduced, mainly as a result of a shorter recovery time ($US237 vs $US475). However, there was no further evidence of any cost effectiveness of methotrexate therapy when hospitalisation was required. In conclusion, single-dose methotrexate appeared to be the most economic approach for the treatment of unruptured ectopic pregnancy. Selection of cases is mandatory to guarantee a cost savings for the treatment of unruptured ectopic pregnancy.