CoChat
Sign Up
Cited by 58Reproductive Health and ContraceptionHealth Systems, Economic Evaluations, Quality of LifeReproductive System and Pregnancy

Economic evaluation of misoprostol in the treatment of early pregnancy failure compared to curettage after an expectant management

Graziosi, G.C.M., van der Steeg, J.W., Reuwer, P.H.W., Drogtrop, A.P., Bruinse, H.W., Mol, B.W.J.·2005·Human Reproduction
DOI 10.1093/humrep/deh709
Open this paper in CoChat — free account

Abstract

BACKGROUND: The increased pressure on health care expenses implies that physicians should consider economic aspects as part of the clinical decision-making process. Direct and indirect costs of a strategy starting with misoprostol in treatment of early pregnancy failure as compared to curettage is therefore performed. METHODS: We performed a cost-minimization analysis alongside a multicentre randomized trial. Clinical data and data on the use of medical resources were obtained from a randomized trial comparing misoprostol and curettage, which had shown that misoprostol reduced the need for curettage in 53%. In a sensitivity analysis the percentage of women who needed curettage after misoprostol varied between 25 and 90%. RESULTS: Direct costs per case were significantly lower in the misoprostol group (mean 433) than in the curettage group (mean 683) (mean difference 250, 95% CI 184 to 316, P < 0.001). These significant differences existed under a wide range of alternative assumptions about unit costs. The differences in direct cost in favour of misoprostol were large for women who had complete evacuation after initial misoprostol treatment as compared to those who needed additional curettage after failed misoprostol. Mean indirect costs were equal for both groups (misoprostol mean 486; curettage mean 428; mean difference 60, 95% CI -61 to 179, P = 0.51). The mean total costs for a strategy starting with misoprostol was 915 versus 1107 for curettage, with a mean difference between both groups of 192 (95% CI 33 to 351, P = 0.04). An increase of the complete evacuation rates for initial misoprostol therapy to 90% in the sensitivity analysis increased the cost difference between misoprostol and curettage to 550. CONCLUSION: The use of misoprostol for early pregnancy failure after failed expectant management is less costly than curettage.

Integrity signals

Registry

Crossref · 10.1093/humrep/deh709

Cites

14 of 14 references verified0 citation errors · 0 not checkable

Statistics

Recomputing p-values needs the paper’s full text.

Claims the paper makes

This paper’s full text isn’t openly available, so its claims and self-check weren’t run. The registry and citation checks still apply.

Claims other papers make about this one

Each is checked against this paper’s own text: does it say what the citing paper says it does?

Cites

Flagged first, then by citations

Cited by

Sorted by citations

Related

Authors
Graziosi, G. C. M., van der Steeg, J. W., Reuwer, P. H. W., Drogtrop, A. P., Bruinse, H. W., & Mol, B. W. J.
Affiliations
  • St. Antonius Ziekenhuis (NL)
  • Elisabeth-TweeSteden Ziekenhuis (NL)
  • University Medical Center Utrecht (NL)
  • Amsterdam UMC Location University of Amsterdam (NL)
Corresponding author
Graziosi, G.C.M.
ORCID
Venue
Human Reproduction
Publisher
Oxford University Press (OUP)
Published
2005-04-01
Volume
20
Issue
4
Pages
1067-1071
ISSN
  • 0268-1161 (ISSN-L)
  • 1460-2350
DOI
10.1093/humrep/deh709
OpenAlex
W2158095191
Cited by
58
References
14
Citations by year
2026: 1 · 2024: 1 · 2023: 3 · 2022: 1 · 2021: 3 · 2020: 2 · 2019: 4 · 2018: 2 · 2017: 5 · 2016: 2 · 2015: 4 · 2014: 7 · 2013: 3 · 2012: 2
FWCI
2.73
Type
journal article
Language
en
Open access
closed
Locations
  • Human Reproduction (publishedVersion)
  • PubMed (publishedVersion)
  • Pure Amsterdam UMC (publishedVersion)
  • University of Groningen research database (University of Groningen / Centre for Information Technology) (publishedVersion)
  • Data Archiving and Networked Services (DANS) (submittedVersion)
  • University of Groningen research database (University of Groningen / Centre for Information Technology) (submittedVersion)
Topics
  • Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Reproductive Health and Contraception
  • Social Sciences › Economics, Econometrics and Finance › Economics and Econometrics › Health Systems, Economic Evaluations, Quality of Life
  • Life Sciences › Immunology and Microbiology › Immunology › Reproductive System and Pregnancy
Keywords
misoprostol, curettage, early pregnancy failure, expectant management, cost-minimization analysis, direct costs, indirect costs, medical evacuation, abortion treatment, health care costs
MeSH terms
Abortifacient Agents, Nonsteroidal, Adult, Dilatation and Curettage, Health Expenditures, Female, Follow-Up Studies, Humans, Pregnancy, Pregnancy Complications, Pregnancy Trimester, First, Prospective Studies, Misoprostol, Cost Savings

About these checks

Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.

Statistics and arithmetic are recomputed, not judged.

Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.

What counts as a claim ›How we measure confidence ›How we check this ›

Are you an author, or do you see a problem with this page? Request a review