Analisis Efektivitas Biaya Penggunaan Sacubitril/Valsartan Dibandingkan Ramipril pada Pasien Gagal Jantung dengan Hipertensi di RSUP dr. Hasan Sadikin Bandung

Dita Marulin, Irma Melyani Puspitasari, Cherry Rahayu, Neily Zakiyah

Abstract


Berdasarkan hasil uji klinis, penggunaan sacubitril/valsartan mempunyai efektivitas yang lebih baik pada pengobatan pasien gagal jantung kronis dengan pengurangan fraksi ejeksi (HFrEF) bila dibandingkan dengan terapi standar. Namun, efektivitas biaya dengan terapi sacubitril/valsartan pada rawat inap untuk gagal jantung di Indonesia belum diketahui. Penelitian ini bertujuan untuk mengetahui efektivitas biaya terapi sacubitril/valsartan bila dibandingkan dengan terapi standar ACE inhibitor (ramipril) pada pasien gagal jantung dengan hipertensi yang dirawat inap di RSUP dr.Hasan Sadikin Bandung. Pengumpulan data dilakukan secara retrospektif dengan desain studi cross sectional dari rekam medis dan rincian biaya pengobatan pasien gagal jantung periode Januari sampai dengan Desember 2022. Hasil penelitian menunjukkan efektivitas penurunan MAP (Mean Arterial Pressure) pada terapi sacubitril/valsartan dan ramipril berturut-turut 14 mmHg dan 13 mmHg. Sedangkan lama rawat untuk terapi dengan sacubitril/valsartan selama 5 hari dan ramipril selama 6 hari. Total biaya berdasarkan perspektif rumah sakit untuk biaya rawat inap, biaya dokter, biaya pelayanan dan tindakan, biaya obat, biaya alkes, dan biaya laboratorium sebesar Rp 22.823.450 pada terapi sacubitril/valsartan dan Rp 18.121.600 pada terapi ramipril. Nilai Incremental Cost-Effectiveness Ratio (ICER) per penurunan 1 mmHg MAP dan per pengurangan 1 hari rawat yaitu Rp 4.701.800. Hasil analisis sensitivitas menunjukan efektivitas penurunan MAP, pengurangan hari rawat, biaya pelayanan dan tindakan, serta biaya alkes merupakan parameter yang berpengaruh terhadap ICER.  Dari hasil penelitian dapat disimpulkan bahwa sacubitril/valsartan memiliki efektivitas terapi dan biaya yang lebih tinggi dibandingkan ramipril, dimana efektivitas obat merupakan faktor yang paling mempengaruhi nilai ICER.

Keywords


efektivitas biaya; gagal jantung; hipertensi; ramipril; sacubitril/valsartan

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DOI: https://doi.org/10.15416/ijcp.2023.12.2.86

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