Abstract
Hypertension medication is taken for a long period and thus requires considerable costs. As antihypertensives vary in efficacy, research is needed to assess the cost effectiveness of medication, particularly between candesartan-amlodipine and candesartan-diltiazem combinations on hypertensive outpatients. This study applied a prospective cohort design with outcome observations for three months at a private hospital in Yogyakarta. The outcome used to gauge the cost effectiveness of medication was the achievement of the targeted blood pressure reduction after treatment. The cost effectiveness analysis was conducted through payer’s perspective, namely that of the social security agency (BPJS), with direct medical cost as the cost component measured. Cost effectiveness was analyzed using an average cost effectiveness ratio (ACER), calculated according to the ratio of cost to the outcome percentage of the blood pressure reduction target attainment, and an incremental cost effectiveness ratio (ICER) based on the ratio between differences in cost and outcome in both medication groups. The research subjects consisted of 33 patients, 24 of whom underwent medication with candesartan-amlodipine combination and 9 with candesartan-diltiazem. As many as 81.82% were female and 72.73% were within the age range of 51-70, while their most frequent complication was diabetes mellitus (48.48%). Results revealed the effectiveness of candesartan-amlodipine medication to be 58.33% with an ACER value of IDR 6,617, whereas that of candesartan-diltiazem was 22.22% with an ACER of IDR 29,733. The ICER value was IDR -7607, indicating that candesartan-amlodipine was categorically more cost-effective than candesartan-diltiazem.
Highlights
Hypertension medication is taken for a long period and requires considerable costs
Rata-rata biaya medik langsung per pasien untuk pengobatan selama 3 bulan, terapi kombinasi candesartanamlodipin adalah sebesar Rp 1.168.443,00±664.323,00 lebih kecil dibandingkan rata-rata biaya pasien terapi candesartan-diltiazem sebesar Rp 2.005.766,00±1.199.826,00
Jurnal Fakultas Farmasi Universitas Wahid Hasyim Semarang, 4(2):124133
Summary
Fakultas Farmasi Universitas Ahmad Dahlan, Yogyakarta Jl. Prof. Adanya efektivitas antihipertensi yang berbeda-beda maka perlu dilakukan penelitian yang bertujuan untuk mengetahui efektivitas biaya pengobatan kombinasi candesartan-amlodipin dibandingkan dengan kombinasi candesartandiltiazem pada pasien hipertensi rawat jalan. Penelitian ini dirancang secara Cohort prospektif dengan pengamatan outcame selama 3 bulan di rumah sakit swasta di Yogyakarta. Outcame yang dinilai untuk menilai efektifitas biaya pengobatan adalah penurunan tekanan darah mencapai target setelah pengobatan. Efektivitas biaya pengobatan dianalisis menggunakan ICER (Incrimental Cost Effectiveness Ratio) dihitung berdasarkan rasio antara selisih biaya dan outcame pada kedua kelompok pengobatan. Subyek penelitian yang terlibat sebanyak 33 pasien, 24 pasien pengobatan kombinasi candesartanamlodipin, dan 9 candesartan-diltiazem. Hasil penelitian menunjukkan efektivitas pengobatan candesartanamlodipin 58,33%, sedangkan efektivitas pengobatan candesartan-diltiazem 22,22%. Nilai ICER sebesar Rp -23.187,40, hal ini menunjukkan candesartan-amlodipin mutlak lebih cost effectiveness dari candesartan-diltiazem. Pengobatan kombinasi candesartanamlodipin mutlak lebih cost effectiveness dari candesartan-diltiazem dengan nilai ICER sebesar Rp -23.187,40.
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