Cost Utility Analysis Vildagliptin dan Glimepiride dalam Mencegah Komplikasi Mikrovaskuler menggunakan Model Markov

https://doi.org/10.22146/jmpf.88587

Tri Julia Purnamasari(1), Stella Ilone(2), Didik Setiawan(3*)

(1) Departemen Farmasi Sosial dan Administratif, Fakultas Farmasi, Universitas Muhammadiyah Purwokerto, Jl. KH. Ahmad Dahlan PO BOX 202, Kembaran, Banyumas, 53182
(2) Rumah Sakit Paru Sidawangi, Jl. Pangeran Kejaksan, Sidawangi, Kec. Sumber, Kabupaten Cirebon, 45558
(3) Pusat Studi Ekonomi Kesehatan, Universitas Muhammadiyah Purwokerto, Jl. KH. Ahmad Dahlan PO BOX 202, Kembaran, Banyumas, 53182
(*) Corresponding Author

Abstract


Microvascular complications can occur due to type 2 diabetes mellitus (DM). The cost of therapy increases due to the use of various antidiabetic drugs over a long period. This research is a pharmacoeconomic study that uses the Markov Model to compare costs and utilities in type 2 DM patients who receive metformin+glimepiride and metformin+vildagliptin therapy. Primary data was collected through the EQ5D questionnaire at Cirebon Harbor Hospital and secondary data (transition probability) was collected through a literature study. Characteristics of type 2 DM patients show that the majority of people suffering from this condition are aged between 55 and 59 years. Primary data from the hospital shows that the cost of therapy for controlled type 2 DM patients who receive combination therapy of metformin + glimepiride, and metformin + vildagliptin is Rp. 1,699,400, Rp. 5,807,786, and Rp. 10,100,426, respectively. Secondary data from articles treating type 2 DM shows that the 55-59 year age group is the largest. With an ICER of 61,493,943/QALYS, microvascular prevention in T2DM patients receiving the metformin+vildagliptin combination in Indonesia is considered effective and able to reduce the number of microvascular cases. This is based on the ICER value compared to the Indonesian Government's GDP, namely Rp. 71,030,183.3. This study shows that replacing glimepiride with vildagliptin for the prevention of microvascular complications is cost-effective and has better utility and effectiveness in reducing the incidence of microvascular complications. The use of vildagliptin can be recommended to reduce costs and the risk of microvascular complications.


Keywords


Vildagliptin; ICER; Markov Model; Utilitas

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References

  1. Tsuchiya T, Teramachi H, Ohta H, et al. Pharmacoeconomic analysis of DPP-4 inhibitors. Pharmazie. 2013;(11):909-915. doi:10.1691/ph.2013.3595
  2. IDF( International Diabetes Federation). Jumlah Penderita DIabetes Indonesia. Published online 2021.
  3. Corina. Profil Komplikasi Kronis Pada Pasien Diabetes Melitus Tipe II Di Poli Endokrin RSUD Dr. Soetomo Periode juli-september 2017. Published online 2018.
  4. Stratton IM. Association of glycaemia with macrovascular and microvascular complications of type 2 diabetes (UKPDS 35): prospective observational study. BMJ. 2000;321(7258):405-412. doi:10.1136/bmj.321.7258.405
  5. Baroroh, Baroroh F, Fauzi, Affianti L. Analisis Biaya Terapi Stroke pada Pasien Rawat Inap di Rumah Sakit PKU Muhammadiyah Bantul Yogyakarta. Akademi Farmasi ISFI Banjarmasin. Published online 2017.
  6. Avogaro A, Fadini GP. The Effects of Dipeptidyl Peptidase-4 Inhibition on Microvascular Diabetes Complications. Diabetes Care. 2014;37(10):2884-2894. doi:10.2337/dc14-0865
  7. Scherbaum WA, Schweizer A, Mari A, et al. Evidence that vildagliptin attenuates deterioration of glycaemic control during 2-year treatment of patients with type 2 diabetes and mild hyperglycaemia*. Diabetes, Obesity and Metabolism. 2008;10(11):1114-1124. doi:10.1111/j.1463-1326.2008.00875.x
  8. Kolaczynski WM, Hankins M, Ong SH, Richter H, Clemens A, Toussi M. Microvascular Outcomes in Patients with Type 2 Diabetes Treated with Vildagliptin vs. Sulfonylurea: A Retrospective Study Using German Electronic Medical Records. Diabetes Ther. 2016;7(3):483-496. doi:10.1007/s13300-016-0177-8
  9. Setiawan D, et al. Farmakoekonomi Modeling. UMP Press; 2017.
  10. Putri RrEK, Darmawan E, Perwitasari DA. Cost of Illness Diabetes Melitus Tipe 2 dan Komplikasinya pada Peserta Jaminan Kesehatan Nasional (JKN) di Rawat Jalan Rumah Sakit Condong Catur Yogyakarta. Pharmacon. 2019;16(2):89-101. doi:10.23917/pharmacon.v16i2.8915
  11. Marzuk RH, Oetari R, Hanifah IR. Analisis Efektivitas Biaya Terapi Metformin dan Glimepiride pada Pasien Diabetes Melitus Tipe 2 dI RSUD dr. Darsono Pacitan Tahun 2019. Jurnal Ilmu Farmasi dan Farmasi Klinik (JIFFK). 2023;Vol.20, No.1:Hal. 20-27.
  12. Trisnawati S, Widarsa IKT, Suastika K. Faktor risiko diabetes mellitus tipe 2 pasien rawat jalan di Puskesmas Wilayah Kecamatan Denpasar Selatan. phpma. 2013;1(1):69-73. doi:10.15562/phpma.v1i1.164
  13. Ramadhan N, Marissa N. Karakteristik Penderita Diabetes Melitus Tipe 2 berdasarkan Kadar HbA1C di Puskesmas Jayabaru Kota Banda Aceh. sel. 2015;2(2):49-56. doi:10.22435/sel.v2i2.4637.49-56
  14. Saputra MD, Muflihatin SK. Hubungan Stres dengan Terkendalinya Kadar Gula Darah pada Pasien DM Tipe II di Irna RSUD Abdul Wahab SjahranieSamarinda. Borneo Student Research. 2020;Vol 1, No 3.
  15. Setiawan D, et al. Farmakoekonomi Modeling. UMP Press; 2017.
  16. Toi PL, Wu O, Thavorncharoensap M, et al. Economic evaluation of population-based type 2 diabetes mellitus screening at different healthcare settings in Vietnam. PLoS ONE. 2021;16(12 December):1-18. doi:10.1371/journal.pone.0261231
  17. Wang H, Wang M, Wang J, et al. Cost-effectiveness analysis of comprehensive intervention programs to control blood glucose in overweight and obese type 2 diabetes mellitus patients based on a real-world setting: Markov modeling. Annals of Translational Medicine. 2019;7(22):676-676. doi:10.21037/atm.2019.10.38
  18. Kim J, Yoon SJ, Jo MW. Estimating the disease burden of Korean type 2 diabetes mellitus patients considering its complications. PLoS ONE. 2021;16(2 February):1-13. doi:10.1371/journal.pone.0246635
  19. Aliyari R, Hajizadeh E, Aminorroaya A, Sharifi F, Kazemi I, Baghestani AR. Multistate models to predict development of late complications of type 2 diabetes in an open cohort study. Diabetes, Metabolic Syndrome and Obesity. 2020;13:1863-1872. doi:10.2147/DMSO.S234563
  20. Janssen MF, Lubetkin EI, Sekhobo JP, Pickard AS. The use of the EQ-5D preference-based health status measure in adults with Type 2 diabetes mellitus: The use of EQ-5D in Type 2 diabetes. Diabetic Medicine. 2011;28(4):395-413. doi:10.1111/j.1464-5491.2010.03136.x
  21. Lin WQ, Cai Z jie, Chen T, Liu MB, Li N, Zheng B. Cost-Effectiveness of Dipeptidylpeptidase-4 Inhibitors Added to Metformin in Patients With Type 2 Diabetes in China. Front Endocrinol. 2021;12:684960. doi:10.3389/fendo.2021.684960
  22. Andayani TM, Kristina SA, Endarti D, Wahyuni ST, Rahmawati A. Health utility score in type 2 diabetes mellitus. Pharm Sci Asia. 2020;47(3):246-252. doi:10.29090/psa.2020.03.019.0040
  23. Kousoulakou H, Hatzikou M, Baroutsou V, Yfantopoulos J. Cost effectiveness of vildagliptin versus glimepiride as add-on treatment to metformin for the treatment of diabetes mellitus type 2 patients in Greece. Cost Eff Resour Alloc. 2017;15(1):19. doi:10.1186/s12962-017-0082-7
  24. Deerochanawong C, Vareesangthip K, Piyayotai D, Thongsuk D, Pojchaijongdee N, Permsuwan U. Cost–Utility Analysis of Dapagliflozin as an Add-On to Standard Treatment for Patients with Type 2 Diabetes and High Risk of Cardiovascular Disease in Thailand. Diabetes Therapy. 2021;12(7):1947-1963. doi:10.1007/s13300-021-01088-w



DOI: https://doi.org/10.22146/jmpf.88587

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