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Pharmacoeconomic analysis of medical abortion in Bulgaria

D. Marinov, E. Grigorov, V. Belcheva, Sl. Djambazov


The drug treatment for interrupting early pregnancy begins with the identification of prostaglandins. In the 1970s, many developed countries legalized abortion, which led to the development and active application of this healthcare technology worldwide.

The cost-effectiveness method was used in the pharmacoeconomic analysis by comparing the costs of abortion of two of the most popular protocols and dosage regimens with the medicines available at the time of the study on the Bulgarian market and the costs of classic abortion. The eventual complications were also noted. With equivalent efficiency of the two procedures, the application of cost-minimum analysis (CMA) is an appropriate and logical choice.

The analysis shows that the drug termination of pregnancy under the EMA protocol is (600 mg Mifepristone + 400 mcg Misoprostol) a slightly higher cost per patient compared to the surgical abortion if the procedure is performed during the first trimester of pregnancy (∆Costs = +10,61 BGN) and leads to cost savings for the patient during the second trimester of pregnancy (∆Costs = -90,96 BGN). Medication termination of pregnancy under WHO protocol results in a cost-saving per patient compared to surgical abortion, regardless of the period of pregnancy during which the procedure is performed (∆Cost = -50,43 BGN in the first trimester and ∆Cost = -156,60 BGN in the second trimester).

Drug termination is non-invasive, highly effective, and safe, resembling the natural mechanism of spontaneous abortion. In most cases, medical abortion is cost-saving and can be considered as a reasonable alternative to surgical abortion.


medical abortion, mifepristone, misoprostol, termination of pregnancy, cost-minimization analysis (CMA)

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