Cost Effectiveness Analysis Therapy Combination of Candesartan-Amlodipine and Candesartan-Diltiazem on Hypertensive Outpatients

Faridah Baroroh, Andriana Sari

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.

Keywords


Cost effectiveness analysis, hypertension, candesartan-amlodipine, candesartan-diltiazem

References


Andayani, T.M., 2013., Farmakoekonomi (Prinsip dan Metodologi), Bursa Ilmu Yogyakarta, 14

Barton, M. and Meyer, M.R., 2009, Postmenopausal Hypertension Mechanism and Therapy, Hypertension, 54 (11)

Dalimartha, S., Purnama, B.T., Sutarina, N., Mahendra, B., dan Darmawan, R., 2008, Care Your Self Hipertensi, 13-15, Penebar Plus+, Jakarta

Lingga, Lanny, 2012, Bebas Hipertensi Tanpa Obat, 39-40, AgroMedia Pustaka, Jakarta.

Maas, A.H.E.M. and Franke, H.R., 2009, Women’s Health in Menopause with a Focus on Hypertension , Netherland Hearh Journal, 17 (2) : 69

Nike, N.W., Mukaddas, A., Rinaldi, M, T., 2016, Analisis Efektifitas Biaya Pengobatan Kombinasi Amlodipin Furosemid Dibandingkan dengan Kombinasi Amlodipin Bisoprolol pada Pasien Hipertensi Rawat Jalan di RSUD Undata Palu Periode Agustus-Oktober Tahun 2014, Online Jurnal of Natural Science, Vol.5 (1) : 101-110

Rustiani, E., Andradjati, R., Arsyanti, L., 2014, Analisis Penggunaan Obat Antihipertensi di Poliklinik Rawat Jalan Rumah Sakit PMI Bogor: Perbandingan Cost Effectiveness dan Kualitas Hidup Pasien, Jurnal Ilmu Kefarmasian Indonesia, 12 (2): 210

Sumarni, Sri., Amiruddin, Ridwan., Leida, Ida M. Thaha. 2015. Faktor Yang Berhubungan Dengan Kualitas Hidup Penderita Hipertensi Di Wilayah Kerja Puskesmas Segeri,Jurnal Unhas, Bagian Epidemiologi Fakultas Kesehatan Masyarakat Universitas Hasanuddin, Sulawesi

Supraptia, Budi., Nilamsari, W.P., Hapsari, P.P., Muzayana, H.A., dan Firdausi, H., 2014, Permasalahan Terkait Obat Antihipertensi pada Pasien Usia Lanjut di Poli Geriatri RSUD Dr.Soetomo Surabaya, Jurnal Farmasi dan Ilmu Kefarmasian Indonesia, 1 (2): 37

Tedjasukmana, Pradana, 2012, Tata Laksana Hipertensi, Departemen Kardiologi, RS Premier Jatinegara dan RS Grha Kedoya, Jakarta, Indonesia. CDK-192/ vol. 39 no. 4

Timur,W.W., Andayani, T.M., Aribawa, R., 2012., Analisis Efektifitas Biaya Kombinasi Antihipertensi Oral Pasien Hipertensi Rawat Jalan di Rumah Sakit Umum Daerah Tugurejo Semarang Periode 2007, Jurnal Fakultas Farmasi Universitas Wahid Hasyim Semarang, Vol.4 (2) : 124-133

Wells, B.G., Dipiro, J.T., Schwinghammer, T.L., Dipiro, C.V. 2009. Pharmacoterapy Handbook seventh edition, Mc Graw Hill; 10 : 111.

Wijayanti, N.W., Mukaddas, A., dan Tandah, M.R., 2016, Analisis Efektifitas Biaya Pengobatan Kombinasi Amlodipin Furosemid Dibandingkan dengan Kombinasi Amlodipin Bisoprolol pada Pasien Hipertensi Rawat Jalan di RSUD Undata Palu Periode Agustus-Oktober Tahun 2014, Jurnal of Natural Science, 5(1) : 101-110


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DOI: 10.30595/pharmacy.v14i2.1952

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ISSN: 2579-910X