Analisis Efektivitas Biaya Penggunaan Antibiotik pada Pasien Community-acquired Pneumonia di RSUP Dr. Hasan Sadikin Bandung
Abstract
Community-acquired Pneumonia (CAP) merupakan penyakit infeksi yang memiliki mortalitas, morbiditas dan biaya yang tinggi. Studi farmakoekonomi diperlukan untuk menganalisis pemilihan kombinasi antibiotik yang bervariasi dengan mempertimbangkan biaya dan efektivitas. Penelitian ini bertujuan untuk menganalisis nilai cost-effectiveness kombinasi antibiotik azitromisin-seftriakson dan kombinasi azitromisin-sefotaksim pada pengobatan CAP di RSUP Dr. Hasan Sadikin Bandung serta menganalisis faktor yang paling berpengaruh terhadap nilai cost-effectiveness. Pengumpulan data dilakukan secara retrospektif dari rekam medis pasien dan Sistem Informasi Rumah Sakit (SIRS). Penelitian ini dilakukan pada bulan Maret–Juni 2019. Data biaya meliputi total biaya medik dari rumah sakit/healthcare perspective (biaya obat, alat kesehatan, tindakan, pemeriksaan, jasa dokter, dan rawat inap) dan total biaya dari Badan Penyelenggara Jaminan Sosial (BPJS)/payer perspective (tarif INA–CBG). Nilai efektivitas pada penelitian ini diukur dalam penurunan jumlah leukosit. Hasil menunjukkan nilai Average Cost-effectiveness Ratio (ACER) pada kombinasi azitromisin-seftriakson dari payer dan healthcare perspective secara berturut-turut adalah Rp2.987 dan Rp2.080 per penurunan 1 sel leukosit/mm3, lebih tinggi dibandingkan kombinasi azitromisin-sefotaksim yaitu Rp2.853 dan Rp1.184 per penurunan 1 sel leukosit/mm3. Berdasarkan hasil perhitungan Incremental Cost-effectiveness Ratio (ICER), diketahui penggantian kombinasi azitromisin-seftriakson oleh azitromisin-sefotaksim akan menghemat biaya sebesar Rp4.531 (payer perspective) dan Rp22.379 (healthcare perspective). Hasil uji sensitivitas menunjukan penurunan leukosit dan biaya rawat inap memiliki rentang yang paling panjang. Kombinasi antibiotik azitromisin-sefotaksim lebih cost-effective dibandingkan azitromisin-seftriakson. Faktor yang paling memengaruhi nilai ICER adalah penurunan leukosit dan biaya rawat inap.
Kata kunci: ACER, analisis efektivitas biaya, CAP, ICER, leukosit
Cost-effectiveness Analysis of Antibiotic of Patients with Community-acquired Pneumonia in Dr. Hasan Sadikin General Hospital Bandung
Abstract
Community-acquired Pneumonia (CAP) is an infectious disease with high mortality, morbidity, and cost. A study of pharmacoeconomics is required to analyze the efficiency of various antibiotic combinations. This study aimed to investigate the cost-effectiveness values on the use of azithromycin-ceftriaxone and azithromycin-cefotaxime in the treatment of CAP at Dr. Hasan Sadikin General Hospital and to analyze the most influential factor impacting the cost-effectiveness value. Data collection was conducted retrospectively from the patient’s medical record and the Hospital Information System (SIRS). This research was conducted in March–June 2019. The total medical costs were reviewed in the healthcare perspective (drug costs, medical devices, action costs, examination fees, doctor fees and the cost of hospitalization) and payer perspective (Social Security Administrator for Health, BPJS) (INA-CBG). The value of effectiveness was measured in the reduction of leukocytes. The results showed that the Average Cost-effectiveness Ratios (ACERs) of azithromycin-ceftriaxone from the payer and healthcare perspective in a row were 2.987 IDR and 2.080 IDR per 1 cell/mm3 leukocytes reduction, higher than azithromycin-cefotaxime 2.853 IDR and 1.184 IDR per 1 cell/mm3 leukocytes reduction. Based on the calculation of the Incremental Cost-effectiveness Ratio (ICER), if azithromycin-ceftriaxone is replaced by azithromycin-cefotaxime, it will save 4.531 IDR (payer perspective) and 22.379 IDR (healthcare perspective) per 1 cell/mm3 leukocytes reduction. It can be concluded that the combination of azithromycin-cefotaxime is more cost-effective than azithromycin-ceftriaxone. The reduction of leukocytes and the cost of hospitalization were the most influential parameters impacting the ICER.
Keywords: ACER, CAP, cost-effectiveness analysis, ICER, leukocytes
Keywords
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DOI: https://doi.org/10.15416/ijcp.2019.8.3.228
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