{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,15]],"date-time":"2026-04-15T17:59:12Z","timestamp":1776275952620,"version":"3.50.1"},"reference-count":34,"publisher":"Wiley","issue":"12","license":[{"start":{"date-parts":[[2025,12,17]],"date-time":"2025-12-17T00:00:00Z","timestamp":1765929600000},"content-version":"vor","delay-in-days":16,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"},{"start":{"date-parts":[[2025,12,1]],"date-time":"2025-12-01T00:00:00Z","timestamp":1764547200000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/100012021","name":"Iran University of Medical Sciences","doi-asserted-by":"publisher","award":["17515.1399"],"award-info":[{"award-number":["17515.1399"]}],"id":[{"id":"10.13039\/100012021","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Health Science Reports"],"published-print":{"date-parts":[[2025,12]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background and Aims<\/jats:title>\n                    <jats:p>The development of prostaglandins and antiprogestins revolutionized medical abortion by providing effective nonsurgical options for terminating pregnancy. Although both strategies are accepted in practice, variations in clinical efficacy, patient experiences, and associated costs significantly influence their overall effectiveness. We aimed to evaluate the cost\u2010effectiveness of hospital\u2010 and clinic\u2010based misoprostol administration (as a medical intervention) compared to dilation and curettage (D&amp;C) as a surgical intervention for early pregnancy termination in Iran.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This cost\u2010effectiveness study was conducted based on clinical data from a self\u2010designed quasi\u2010experimental research study in three Iranian hospitals, spanning from August 1, 2021 to March 30, 2022. Participants included 168 women diagnosed with induced abortion in early pregnancy (\u2264\u200914 weeks of gestation). We calculated costs, outcomes (Quality\u2010Adjusted Life Years), and incremental cost\u2010effectiveness ratios (ICER) from a societal perspective over a 14\u2010day time horizon starting from the date of initiation of treatment. A decision tree model using TreeAge Pro Healthcare software 2022 was employed.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>The overall societal costs of hospital\u2010based misoprostol, D&amp;C, and clinic\u2010based misoprostol strategies were estimated at $135.1, $138.3, and $158.2, respectively. The QALYs for hospital\u2010based misoprostol, clinic\u2010based misoprostol, and D&amp;C were estimated at 0.6891, 0.3947, and 0.6604, respectively. The ICERs of D&amp;C and clinic\u2010based misoprostol strategies were calculated as $109 and $79 per QALY, respectively.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>This study indicates that using misoprostol administered in hospitals for first\u2010trimester induced abortions in Iran not only reduces societal costs but also improves quality of life compared to both D&amp;C procedures and clinic\u2010based misoprostol administration.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/hsr2.71662","type":"journal-article","created":{"date-parts":[[2025,12,17]],"date-time":"2025-12-17T14:25:21Z","timestamp":1765981521000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Clinical Effectiveness and Cost\u2010Effectiveness of Misoprostol in Comparison to Dilatation and Curettage for Treatment of First\u2010Trimester Missed Abortion (Gestational Age\u2009\u2264\u200914 Weeks) in Iran"],"prefix":"10.1002","volume":"8","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-5322-2438","authenticated-orcid":false,"given":"Saeed","family":"Husseini Barghazan","sequence":"first","affiliation":[{"name":"Department of Health Economics, School of Health Management and Information Sciences Iran University of Medical Sciences Tehran Iran"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5897-659X","authenticated-orcid":false,"given":"Mohamad","family":"Hadian","sequence":"additional","affiliation":[{"name":"Department of Health Economics, School of Health Management and Information Sciences Iran University of Medical Sciences Tehran Iran"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5583-5561","authenticated-orcid":false,"given":"Aziz","family":"Rezapour","sequence":"additional","affiliation":[{"name":"Health Management and Economics Research Center Iran University of Medical Sciences Tehran Iran"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6900-7345","authenticated-orcid":false,"given":"Setare","family":"Nassiri","sequence":"additional","affiliation":[{"name":"Endometriosis Research Center Iran University of Medical Sciences Tehran Iran"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7994-2567","authenticated-orcid":false,"given":"Zahra","family":"Meshkani","sequence":"additional","affiliation":[{"name":"Health Management and Economics Research Center Iran University of Medical Sciences Tehran Iran"},{"name":"National Center for Health Insurance Research  Tehran Iran"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3028-7861","authenticated-orcid":false,"given":"Soheila","family":"Norouzi","sequence":"additional","affiliation":[{"name":"Department of Health Management and Economics, School of Public Health Urmia University of Medical Sciences  Urmia Iran"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2025,12,17]]},"reference":[{"key":"e_1_2_13_2_1","doi-asserted-by":"publisher","DOI":"10.21608\/aimj.2025.448371"},{"key":"e_1_2_13_3_1","volume-title":"Abortion","author":"World Health Organization","year":"2025"},{"key":"e_1_2_13_4_1","doi-asserted-by":"publisher","DOI":"10.34172\/aim.34080"},{"key":"e_1_2_13_5_1","article-title":"Unsafe Abortion in Brazil: A Systematic Review of the Scientific Production, 2008\u20102018","volume":"36","author":"Domingues R. 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