Analysis of Cost-Effectiveness of Antihypertensive Therapy in Hypertension Patients at Al-Ihsan Regional Public Hospital in 2023

Masyitah Isnaini, Widiah Widiarti, Miski A. Khairinisa

Abstract


Hypertension is a disease that causes an abnormal increase in blood pressure, which causes cardiovascular disease. Long-term hypertension therapy requires large costs. Apart from that, existing antihypertensives are also very varied, so a cost-effectiveness analysis is needed in order to choose medications that balance costs and advantages. This study aims to determine the most economical antihypertensive medication at Al-Ihsan Regional Public Hospital in Baleendah. Based on patient medical records, this study was carried out retrospectively. Therapy data and treatment costs are the basis for the data collection process. The data is processed descriptively. The reduction in blood pressure that meets the target and the length of stay (LOS) is used to determine how effective the therapy was; the ACER and ICER values are used to determine how cost-effective the procedure was. According to the research findings, the average total cost of group A (ACEI with CCB) is IDR 2,311,000.00, whereas group B (ARB with CCB) is IDR 2,888,823.00. The efficacy of group A (ACEI with CCB) was 83.3%, while group B (ARB with CCB) was 52.4%. The findings showed that among inpatient hypertension patients at Al-Ihsan Regional Public Hospital, group A (ACEI with CCB) was more cost-effective, with an Average Cost Effectiveness Ratio (ACER) value of IDR 27,743,097, than group B (ARB with CCB ACER value of IDR 55,130,209). Based on this study, therapy of group A (ACEI with CCB) offers excellent therapeutic efficacy at a reduced cost. Hospitals are expected to have the ability to handle their spending on hypertension medications appropriately and efficiently.


Keywords


Hypertension; Cost Effectiveness Analysi; Combination Of Antihypertensive

Full Text:

PDF

References


Brunner & Suddart (2020). Keperawatan Medikal-Bedah Edisi 12. Alih bahasa Yulianti, D., and Kimin, A. Jakarta: ECG.

G, Spiering W, Agabiti RE, Azizi M, Burnier M, et al. (2018). ESC Scientific Document

Group. ESC/ESH Guidelines for the Management of Arterial Hypertension. Eur Heart J, 39:3021104.

Dinas Kesehatan Provinsi Jawa Barat. (2023). Profil Kesehatan Jawa Barat 2023. Dinkes Jabar. Kabupaten Bandung

Sumiati, L., Citraningtyas, G., & Yudistira, A. (2018). Analisis Efektivitas Biaya Terapi Antihipertensi Pada Pasien Hipertensi Rawat Inap Di RSU Pancaran Kasih Gmim Manado. Pharmacon, 7(1), 1–9.

Muniati, A. (2018). Analisis Efektivitas Biaya (AEB, CostEffectiveness Analysis/CEA) Penggunaan Antibiotik Pada Pasien Ulkus Kaki Diabetikum di RSUD Dr. Wahidin Sudirohusodo Makassar. Skripsi. Fakultas Kedokteran dan Ilmu Kesehatan, UIN Alauddin. Makassar.

Moran AE, Odden MC, Thanataveerat A, Tzong KY, Rasmussen PW, Guzman D, et al. (2015). Cost-effectiveness of hypertension therapy according to 2014 guidelines. New England Journal of Medicine, 372(5):447-55.

Mutoharoh, N. (2017). Analisis Efektivitas Biaya Antihipertensi Oral Amlodipin dan Candesartan Pada Pasien Hipertensi Rawat Inap RSUD Pandan Arang Boyolali Tahun 2016. Skripsi. Universitas Setia Budi. Surakarta.

Delfriana A.A., Addina F., Nabila S., Siti M.S., Shakila S., Rahmad S.Z., Adellia R., & Anisa T.D. (2022). Faktor-Faktor Yang Menyebabkan Hipertensi Di Kelurahan Medan Tenggara. Jurnal Kesehatan Masyarakat e-Journal, 10(2):136-147

Aryzki, Saftia, & Akrom. (2018). Pengaruh Brief Counseling Terhadap Konsumsi Lemak Pada Pasien Hipertensi Di RSUD Dr. H. Moch Ansari Saleh Banjarmasin. Jurnal Sains Farmasi & Klinis, 5(1): 33–40.

Nuraini, B. (2015). Risk Factors of Hypertension. J Majority, 4(5), pp. 10–19.

Wahyuningtiyas, D. A. (2015). Analisis Efektivitas Biaya Terapi Antihipertensi pada Pasien Hipertensi Rawat Inap di Rumah Sakit Umum Daerah, Dr. Moewardi Tahun 2014. Skripsi. pp. 1–14.

Muhadi. (2016). JNC 8 : Evidence-based Guideline Penanganan Pasien Hipertensi Dewasa. Cermin Dunia Kedokteran, 43(1):54–9.

Gielen, S., de Backer, G., Piepoli, M.F., & Wood, D. (2015). The ESC Textbook of Preventive Cardiology. Oxford University Press, UK.

Folkow B, Johansson B, and Mellander S. The comparative effects of angiotensin and noradrenaline on consecutive vascular sections. Acta Physiol Scand. 1961 Oct;53:99-104.

T. Addei, S., & Bortolotto, L. (2016). Unraveling the pivotal role of bradykinin in ACE inhibitor activity. American Journal of Cardiovascular Drugs, 16(5), 309-321.

Bell L. & Madri JA. Influence of the angiotensin system on endothelial and smooth muscle cell migration. Am J Pathol. 1990 Jul;137(1):7-12.

Silva P, Brown RS, and Epstein FH. Adaptation to potassium. Kidney Int. 1977 Jun;11(6):466-75.

Yee AH, Burns JD, and Wijdicks EF. Cerebral salt wasting: pathophysiology, diagnosis, and treatment. Neurosurg Clin N Am. 2010 Apr;21(2):339-52.

Verdecchia P, Angeli F, Repaci S, et al. Comparative assessment of angiotensin receptor blockers in different clinical settings. Vascular Health Risk Management 2009;5:939-48.

Bumier M. Angiotensin II type 1 receptor blockers. 2001;103:904–912.

Rodgers JE, Patterson JH. Angiotensin II-receptor blockers: clinical relevance and therapeutic role. Am J Health Syst Pharm. 2001;58:671–683.

Neutel JM, Smith DH, Weber MA, Schofield L, Purkayastha D, and Gatlin M. Efficacy of combination therapy for systolic blood pressure in patients with severe systolic hypertension: the Systolic Evaluation of Lotrel Efficacy and Comparative Therapies (SELECT) study. J Clin Hypertens (Greenwich) 2005;7:641–6.

Abernethy DR, Schwartz JB. Calcium‐antagonist drugs. N Engl J Med. 1999;341:1447–1457.

Ansa, Dian, Ariyani. Dkk. (2018). Kajian Penggunaan Obat Antihipertensi Pada Pasien Diabetes Melitus Tipe 2 Di Instalasi Rawat Inap RSUP Prof. Dr. R. D. Kandou Manado Periode Januari-Desember 2010. Skripsi. Program Studi Farmasi FMIPA UNSRAT Manado, 95115

Asyrorsh, S. (2018). Evaluasi Interaksi Obat Pada Pasien Diabetes Mellitus Tipe 2 Dengan Komplikasi Hipertensi Di RSUD Dr. Saiful Anwar Malang Tahun 2016. Skripsi. Jurusan Farmasi Fakultas Kedokteran Dan Ilmu Kesehatan Universitas Islam Negeri Maulana Malik Ibrahim. Malang

Quan A, et al. A review of the efficacy of fixed-dose combinations of olmesartan medoxomil/hydrochlorothiazide and amlodipine besylate/benazepril in factorial design studies. Am J Cardiovasc Drugs 2006;6:103–113.

Messerli FH. Vasodilatory edema: a common side effect of antihypertensive therapy. Am J Hypertens 2001;14:978–9.

Dahlöf B, Sever PS, Poulter NR, Wedel H, Beevers DG, Caulfield M, et al. Prevention of cardiovascular events with an antihypertensive regimen of amlodipine adding perindopril as required versus atenolol adding bendroflumethiazide as required, in the Anglo-Scandinavian Cardiac Outcomes Trial-Blood Pressure Lowering Arm (ASCOT-BPLA): a multicentre randomized controlled trial. Lancet. 2005 Sep 10-16;366(9489):895-906

Sasmita, E. D. (2017). Hubungan Karakteristik Personal Pasien dengan Lama Rawat Pasien Moderate Care di Rumah Sakit Ortopedi Prof. DR. R. Soeharso Surakarta. Skripsi. p. 2.

Kandarini, Y. (2019). Strategi Pemilihan Terapi Kombinasi Obat Anti Hipertensi. SMF Ilmu Penyakit Dalam FK Unud/ RSUP Sanglah Denpasar Pendahuluan, 1–9.




DOI: https://doi.org/10.15416/pcpr.v9i1.54705

Refbacks

  • There are currently no refbacks.


                                                                         
Pharmacology and Clinical Pharmacy Research is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License
 
                                                                      VIEW VISITOR STATS