Observing the uncertainty of the Amlodipine-Candesartan Incremental Cost-Effectiveness ratio using Deterministic Sensitivity Analysis (DSA)

Abstract

Background: Hypertension treatment is carried out for a long time and can cause quite large costs. This study delves into the economic evaluation of Amlodipine-Candesartan combination therapy, a prominent treatment for hypertension. While the clinical benefits of this regimen are well-documented, its cost-effectiveness remains a critical consideration for healthcare systems. Employing Deterministic Sensitivity Analysis (DSA). This study aimed to discern the uncertainty surrounding the Incremental Cost-Effectiveness Ratio (ICER) associated with Amlodipine-Candesartan through comprehensive examination, next to refine economic assessments and offer insights for healthcare policymakers and practitioners. Method: This retrospective descriptive study at Andalas University Hospital in 2021 analyzed hypertension outpatient data. Of 284 patients, 73 were included. Among them, 28.77% received Amlodipine monotherapy, while 71.23% received Amlodipine-Candesartan combination therapy. Results: The ICER for systolic blood pressure was Rp. 74,738.10 per mmHg decrease, and for diastolic blood pressure, it was Rp. 205,918.24 per mmHg decrease. Both of them are in the northeast quadrant. Next, DSA will be carried out by creating a tornado diagram by providing a change range of 20% (min-max) for the input variables in ICER. Conclusion: The use of amlodipine-candesartan requires a higher cost, but the resulting effect is also better. Our findings contribute to the broader discourse on combination therapies and inform resource allocation strategies for hypertension management. This research attempts to enhance the precision of economic evaluations, ultimately facilitating more informed and efficient healthcare decision-making processes. Keywords: Amlodipine, Candesartan, Cost-effectiveness, ICER, DSA.