Comparative Pharmacoeconomy and Effectiveness of Combination Antiplatelet Cost in Patient Ishemic Stroke

Abstract

Stroke is one of the number 3 causes of death in Indonesia which is a cerebrovascular disease and is characterized by brain tissue death that occurs due to reduced blood flow and oxygen to the brain. The effect of ischemia is quite rapid because the brain lacks a supply of glucose and has the ability to anaerobic metabolism. The purpose of this study was to obtain a comparative picture of the cost effectiveness of ischemic stroke therapy with three combination therapy groups. This research is a type of descriptive research with retrospective data collection methods from tracking patient medical records and patient drug costs. The research subjects were 126 patients with a diagnosis of ischemic stroke who were hospitalized during January 2018 to June 2019 who met the inclusion criteria and were divided into three groups where the first group (K1) was a group of patients who received a combination of clopidogrel-aspirin antiplatelet, the second group (K2) is a group of patients who receive a combination of DA-clopidogrel-defibrogenating agent and third group (K3) who receive three types of drugs namely, clopidogrel, aspirin and Defibrogenating Agent (D®). Analysis of the effectiveness data in this study was based on the percentage of research subjects who had experienced a decrease in blood pressure during hospitalization. K1 combination therapy reached 67.62% with an average duration of hospitalization of 5.2 days and an average drug cost of Rp 14,063.31. K2 reached 83.33% with an average duration of hospitalization of 4 days and an average drug cost of Rp 117,521. K3 reaches 100% with an average duration of hospitalization of 5.7 days and an average cost of medication Rp 159,048. Second group antiplatelet combination therapy is more cost effective, because the duration of hospitalization is shorter and the target of reducing blood pressure achieved is more optimal.