The costs of treating miscarriage: a comparison of medical and surgical management

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Abstract
Objective To estimate and compare the costs of surgical and medical treatment of miscarriage to the National Health Service. Design A patient-centred, partially randomised trial. Setting A teaching hospital in Scotland. Participants Four hundred and thirty-seven women with a proven first trimester miscarriage. Main outcome measures The cost per patient of surgical and medical management of miscarriage plus the extra cost per patient of introducing medical management of miscarriage under three different scenarios are calculated. Results The average cost of surgical treatment was £397 compared with £347 for medical treatment. Sensitivity analysis showed that the extra cost of introducing the medical management of miscarriage ranged from a cost saving of £71 per patient to an additional cost of £37 per patient. Conclusions Our analysis showed that it may be possible to generate cost savings by introducing medical methods in the management of early miscarriage. However, the savings assume that costs associated with theatre use can be fully realised.