Analisis Efektivitas Biaya Terapi Antihipertensi Kombinasi Tetap Di Satu Rumah Sakit Jakarta Selatan

https://doi.org/10.22146/jmpf.43667

Ani Rahayu(1*), Ahmad Fuad Afdhal(2), Delina Hasan(3), Feriadi Suwarna(4), Okpri Meila(5)

(1) Magister Ilmu Kefarmasian, Farmasi Rumah Sakit, Universitas Pancasila, Jakarta Selatan
(2) Program Studi Magister Ilmu Kefarmasian, Universitas Pancasila, Jakarta Selatan
(3) Program Studi Magister Ilmu Kefarmasian, Universitas Pancasila, Jakarta Selatan
(4) Bagian Polikinik Penyakit Dalam, Rumah Sakit Swasta Tipe B Kuningan Jakarta Selatan
(5) Jurusan Farmasi, Fakultas Matematika dan Ilmu Pengetahuan Alam, Universitas Syiah Kuala, Banda Aceh
(*) Corresponding Author

Abstract


The majority of alternative antihypertensive therapies require pharmacoeconomic studies, particularly Cost Effectiveness Analysis, which is useful in balancing patients’ expenditure by determining alternative treatments that represented the most plausible health outcomes with a more reasonable budget. The objective of this study was to compare the cost effectiveness using antihypertensive fixed dose combinations (FDC) of Valsartan-Amlodipine + Furosemide and FDC of Valsartan-HCT + Amlodipin. This research applied the descriptive analytical cross-sectional method and conducted data collection retrospectively from the medical record of hypertensive patients. Meanwhile, the medication cost breakdown was obtained from Outpatient Financial Department of a Type B Hospital in south Jakarta for the period of January - June 2018. Total sample were 74 patients, consisted of 37 patients who used  FDC of Valsartan-Amlodipin + Furosemide, and 37 patients who used FDC of Valsartan-HCT + Amlodipin. The parameters of this research were direct medication cost (consisted of examination cost, laboratory cost and medicines cost), indirect medication cost (consisted accommodation cost and lost productivity cost), while the effectiveness used the MAP average (Mean Arterial Pressure). The result of this research showed that the biggest medication effectiveness to lower the blood pressure is FDC of  Valsartan-Amlodipin + Furosemide, with 32  patients had the average MAP 101,29 mmHg, while the FDC of Valsartan-HCT + Amlodipin with 29 patients had the average MAP 103,59 mmHg. The cost effectiveness based on ACER value of  FDC of Valsartan –HCT + Amlodipin and FDC Valsartan-HCT + Amlodipin sequentially is Rp 3.922.040/MAP and Rp 4.458.034/MAP. In conclusion, the FDC of Valsartan-Amlodipin + Furosemide  was more cost-effective.

Keywords


effective and efficient; fixed combination antipertension; fdc valsartan-amlodipin + furosemide; fdc valsartan-hydroklorothiazide; hypertension

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References

  1. Riset Kesehatan Dasar 2013. Badan Penelitian dan Pengembangan Kesehatan, Kementerian Kesehatan RI; 2013. 1-268 .
  2. Bernard W, Luis MR. Amlodipine and Valsartan As Component Of a Rational And Effective Fixed Dose Combination, Vascular Health and Risk Management 2009; 145-174.
  3. World Health Organization (WHO). Global target 6: A 25% relative reduction in the prevalence of raised blood pressure or contain the prevalence of raised blood pressure, according to national circumstances. Jenewa: World Health Organization 2014.
  4. Szucs TD, Burnier M, Erne P. Cost-effectiveness of losartan versus atenolol in treating hypertension - An analysis of the LIFE study from a Swiss perspective. Cardiovasc Drugs Ther. 2004;18(5):391–7
  5. Rustiani E, Andrajati R, Arsyanti L. Analisis Penggunaan Obat Antihipertensi di Poliklinik Rawat Jalan Rumah Sakit PMI Bogor: Perbandingan Cost Effectiveness dan Kualitas Hidup Pasien (Analysis of Usage Antihypertensive Drugs in Outpatient Polyclinic PMI Hospital Bogor: a Comparison of Coste. J Ilmu Kefarmasian Indones [Internet]. 2013;12(2):209–15. Available from: http://jifi.ffup.org/wpcontent/uploads/2015/11/209-215_Erni.pdf. Diakses : 4 Januari 2018
  6. Muhadi. JNC 8 : Evidence-based Guideline Penanganan Pasien Hipertensi Dewasa. Cdk. 2016;43(1):54–9.
  7. Katzung G. Farmakologi Dasar dan Klinik. In: Buku I, Bagian Farmakologi Falkultas Kedokteran Universitas Airlangga. Salemba Medika, Jakarta; 2001. p. 269–71.
  8. Kandarini Y. Tatalaksana Farmakologi Terapi Hipertensi. Div Ginjal dan Hipertensi RSUP Sanglah Denpasar. 2017; 1-6.
  9. Sargowo HD, Fakultas Kedokteran Unversitas Brawijaya. Single Pill Combination in Antihypertensive Therapy. 2012;1–22.
  10. Amol AV, Wayne K, Mina T, Tara G, et all, Fixed dose combination antihypertensive mediucation, adherence, and clinical outcomes : a population-base retrospective cohort study, 2018: 1-18
  11. Gradman AH, Basile JN, Carter BL, Bakris GL. Combination therapy in hypertension. J Am Soc Hypertens [Internet]. 2010;4(2):90–8. Available from : http : // dx . doi . org / 10 . 1016/j.jash.2010.02.005. Diakses : 4 Januari 2018.
  12. DH Zappe, BF Palmer, DA Calhoun, D Purkayastha1, R Samuel and KA Jamerson. Effectiveness of Initiating Treatment With Valsartan/Hydrochlorothiazide in Patients With Stage-1 or Stage-2 Hypertension. Journal of Human Hypertesion 2010-24; 483-491.
  13. Fu-Chih Hsiao, MD, Ying-Chang Tung, MD, Shing-Hsien Chou, MD, Lung-Sheng Wu, MD, Chia-Pin Lin, MD, Chun-Li Wang, MD, Yu-Sheng Lin, MD, Chee-Jen Chang, PhD, and Pao-Hsien Chu, MD. Fixed - Dose Combinations of Renin – Angiotensin System Inhibitors and Calcium Channel Blockers in the Treatmen t of Hypertension A Comparison of Angiotensin Receptor Blockers and Angiotensin - Converting Enzyme Inhibitors 2015;1-10.
  14. Arini Setiawati, Harmani Kalim dan Arif Abdillah. Clinical Effectiveness, Safety and Tolerability of Amlodipine / Valsartan in Hypertensive Patients: the Indonesian Subset of the EXCITE Study. Acta Medica Indonesiana - The Indonesian Journal of Internal Medicine 2015 (Vol 47-3) ; 223-233.
  15. Jorge A, M.D, Shari G.F, M.D. Real World Effectiveness and Safety of Singel Pill Combination of Amlpdipin/Valsartan or Amlodipin/Valsartan/Hudrochlorothiazide in Patients With Hipertention from the Philippines.Philippine Of Internal Medicine 2014 (Vo; 52-4); 1-7
  16. Welliang Z, MD, Yongbin S, MD, Jiangtao X, MD. Effectiveness and Safety of Valsartan/Amlodipin in Hypertensive Patients with Stroke. Medicine 2017 (96:26); 1- 7.
  17. Wili WT, Trimurti A, Riyanta A. Analisis Efektivitas Biaya Kombinasi Antihipertensi Oral Pasien Hipertensi Rawat Jalan Di RSUD Tugurejo Semarang Periode 2007. Sains Medika 2012 (vol 4-2); 124-134.
  18. Aida M, Hasan D dan Hidayat W, Cost Effectiviness Analysis Penggunaan Antihipertensi ACEI-CCB dan ARB-CCB Pada Pasien Hipertensi Rawat Jalan RSUD Gunung Jati Cirebon Periode Januari-Juni 2014". Pancasila; 2014: 1-80
  19. Anwar, T.B. Dislipidemia Sebagai Faktor Resiko Penyakit Jantung Koroner. Medan: Universitas Sumatra Utara. 2004;Diakses tanggal 27 Agustus 2018
  20. Chobanian AV, Bakris GL, Black HR, Cushman WC, Green L A., Izzo JL, Jones DW, Materson BJ, Oparil S, Wright JT, Roccella EJ, The Seventh Report of The Joint National Committee on Prevention Detection, Evaluation, and Treatment of Blood Pressure http://www.ahajournal.org, 2003. Diakses tgl 06-08-2018.
  21. Raharja K dan Tjay TH. Obat-Obat Penting (Khasiat Penggunaan dan Efek-Efek Sampingnya) Edisi V; Alex Media Komputindo, Gramedia, Jakarta , 488-508.
  22. Afdhal AF. Farmakoekonomi Pisau Analisis Terbaru Dunia Farmasi. Jakarta; 2011: 1-30
  23. Kementrian Kesehatan Republik Indonesia. Pedoman Teknis Analisis Farmakoekonomi Di Fasilitas Kesehatan. 2016. 1-100
  24. Niken W, Alwiyah M, Muhammad, Analisis Efektivitas Biaya Pengobatan kombinasi Amlodipin - Furosemide Dibandingkan Dengan Kombinasi Amlodipin-Bisoprolol Pada Pasien Hipertensi Rawat Jalan Di RSUD Undata Palu Periode Agustus - Oktober Tahun 2014. 101-110.



DOI: https://doi.org/10.22146/jmpf.43667

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