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 the methotrexate management versus laparoscopic surgery in the treatment of ectopic pregnancy. A total of 40 patients treated from January 1991 to October 1994 with methotrexate were compared with another 40 patients treated at the same hospital by laparoscopy from April 1986 to June 1994. Medical records for all these patients were received and hospital databases were used to retrieve information on cost. Treatment cost included the primary treatment, hospitalization and outpatient follow-up necessitated by treatment, complications and secondary treatment in cases of treatment failure. The cost related to diagnosis was excluded. The direct medical costs for methotrexate and laparoscopy groups were based on success rates of 72.5 and 95% respectively. The total cost of methotrexate treatment was Canadian $35,180 compared with Canadian $73,440 for the laparoscopic treatment. The mean +/- SD cost per patient was Canadian $880 +/- 160 in the methotrexate group compared with Canadian $1,840 +/- 150 in the laparoscopic group (P < 0.001). The mean +/- SE cost per patient with methotrexate success was Canadian $330 +/- 67 compared with Canadian $2,330 +/- 220 per patient with methotrexate failure (P = 0.001). A complete assessment of methotrexate treatment, including cost-benefit and cost-effectiveness, is warranted.