Cost-Effectiveness Analysis of Different Methods of Treatment of Tubal Ectopic Pregnancy in the South of Iran

The aim of the study was to evaluate the cost-effectiveness of different methods of treating tubal ectopic pregnancy in the south of Iran. This study was an economic evaluation that analyzed and compared the cost-effectiveness and cost utility of 3 treatment methods, including single-dose methotrexate, double-dose methotrexate, and surgery in patients with tubal ectopic pregnancy. In this study, a decision tree model was used. The outcomes included in the model were the percentage of successful treatment and the average utility score of each treatment method. The study was conducted from the social perspective, and a one-way and probabilistic sensitivity analysis was performed to measure the effects of uncertainty. The incremental cost-effectiveness ratio of surgery compared with single-dose methotrexate was positive and equal to $5812 purchasing power parity; moreover, the results of one-way analysis showed the highest sensitivity toward the effectiveness of single-dose methotrexate. Scatter plots also revealed that surgery in 82% and 96% of simulations was at the acceptable region compared with a single-dose and double-dose methotrexate, respectively and was below the threshold. It was identified as a more cost-effective strategy. Furthermore, the acceptability curves showed that in 81.4% of simulations, surgery was the most cost-effective treatment for thresholds less than $20 950 purchasing power parity. On the basis of the results of this study, surgery can be used as the first line of treatment for ectopic pregnancy. In addition, the best drug strategy was single-dose methotrexate because this strategy reduced costs and increased treatment success and quality-adjusted life-years compared with double-dose methotrexate. •Ectopic pregnancy is one of the most important causes of mortality and disabilities in women of reproductive age. The incidence of this disease has increased significantly in the last century, but the rate is currently relatively stable.•Laparoscopy or laparotomies are 2 standard methods used for the treatment of an ectopic pregnancy. Nonetheless, the use of these methods depends on the size and location of the ectopic mass and the hemodynamic stability of the patient.•Successful treatment of ectopic pregnancy can increase the quality of life of patients undergoing treatment and decrease their suffering from mental illness and physical problems after the disease.•Surgery is a superior treatment strategy and can be used as a high-priori