EFEKTIVITAS-BIAYA PENGGUNAAN BEVACIZUMAB DAN RANIBIZUMAB SEBAGAI ANTI-VASCULAR ENDOTHELIAL GROWTH FACTOR PADA PASIEN DENGAN GANGGUAN MATA: TINJAUAN SISTEMATIS

Abstract

Anti-vascular endothelial growth factor (VEGF) injeksi intravitreal dapat digunakan untuk terapi pasien dengan gangguan mata. Obat anti-VEGF yang digunakan di antaranya bevacizumab, ranibizumab, aflibercept, dan brolucizumab. Obat tersebut termasuk ke dalam obat dengan biaya tinggi sehingga harus dipertimbangkan efektivitas-biaya dari setiap obat agar dapat menghemat biaya pengobatan. Tinjauan sistematis ini bertujuan untuk memberikan gambaran secara komprehensif terkait efektivitas-biaya bevacizumab dan ranibizumab. Database yang digunakan adalah PubMed, Science Direct dan Google Scholar. Kriteria inklusi pada penelitian ini adalah penelitian randomized control trial (RCT), clinical trial, dan research article, penelitian yang menjelaskan efektivitas-biaya pemberian injeksi intravitreal bevacizumab dan ranibizumab dan obat lainnya sebagai anti-VEGF untuk pasien dengan gangguan mata. Penelusuran berbasis data elektronik menghasilkan 2414 artikel; 27 artikel dipilih yang dapat diakses full text dan membahas efektivitas-biaya ranibizumab atau bevacizumab, namun hanya 12 artikel yang sesuai dengan inklusi yang ingin ditinjau. Dalam semua penelitian yang ditinjau, pengukuran hasil terapi dinyatakan dengan menilai perbaikan ketajaman penglihatan dan quality adjusted life years (QALY), serta efektivitas dinyatakan dengan nilai incremental cost effectiveness ratio (ICER). Berdasarkan nilai ICER dapat dilihat terapi mana yang lebih efektif-biaya terhadap terapi yang lain. Bevacizumab lebih efektif-biaya dibandingkan dengan ranibizumab. Kata kunci: Anti-VEGF, bevacizumab, efektivitas-biaya, ranibizumab. Abstract Anti-vascular endothelial growth factor (VEGF) given by intravitreal injection can be used to treat patients with eye disorders. The anti-VEGF drugs used include bevacizumab, ranibizumab, aflibercept, and brolucizumab. These drugs are high-cost drugs, so the cost-effectiveness of each drug must be considered in order to save on treatment costs. This systematic review aims to provide a comprehensive picture of the cost-effectiveness of bevacizumab and ranibizumab. The databases used to identify relevant studies are PubMed, Science Direct and Google Scholar. This research is limited to randomized control trials (RCT), clinical trials, and research articles, studies that explain the cost- effectiveness of intravitreal injections of bevacizumab and ranibizumab and other drugs as anti-VEGF for patients with eye disorders, as well as articles in English. Electronic data-based searches resulted in 2414 articles; 27 articles were selected that had full text access and discussed the cost-effectiveness of ranibizumab or bevacizumab, but only 12 articles suitable for inclusion were considered. In all the studies reviewed, the measurement of therapy results was expressed by assessing improvements in visual acuity and quality adjusted life years (QALY), and effectiveness was expressed by the value of the incremental cost effectiveness ratio (ICER). Based on the ICER values, it can be seen which therapy is more cost-effective compared to other therapies. Bevacizumab is more cost-effective than ranibizumab. Keywords: Anti-VEGF, bevacizumab, cost-effectiveness, ranibizumab.