Cost of ectopic pregnancy management: surgery versus methotrexate.

OBJECTIVE

To estimate the potential annual cost savings of methotrexate (MTX) therapy for ectopic pregnancy (EP) at our institution and nationally.

DESIGN

Retrospective.

SETTING

San Francisco General Hospital.

PATIENTS

All patients treated for EP in 1991.

INTERVENTIONS

Medical records and billing statements were reviewed.

MAIN OUTCOME MEASURES

Direct costs were determined from billing statements, and indirect costs were estimated based on published data. Potential annual national cost savings from MTX treatment were then extrapolated using national statistics on the incidence of EP.

RESULTS

Fifty EPs were treated with an average direct cost of $7,972 per case. Direct and indirect costs totaled > $500,000. Fifteen (30%) of the cases would have been eligible for MTX treatment with a resultant cost savings of > $160,000. The potential annual national cost savings would be in excess of $280 million.

CONCLUSIONS

If preliminary findings suggesting the effectiveness of MTX as an alternative therapy for EP are confirmed, appropriate use of MTX will not only reduce morbidity but also the substantial cost.