ABSTRAK
Transfusi darah dibutuhkan dalam meningkatkan kualitas hidup pasien thalassemia mayor, namun dapat menyebabkan kelebihan zat besi, sehingga diperlukan terapi kelasi besi, seperti deferipron dan deferasirox. Tujuan penelitian ini adalah menganalisis obat yang lebih cost-effective dengan metode Analisis Efektivitas-Biaya AEB karena masing-masing obat memiliki perbedaan efektivitas dan biaya obat yang signifikan. Data diambil secara retrospektif dan pengambilan sampel dilakukan secara total sampling berdasarkan catatan rekam medik dan sistem informasi rumah sakit. Pasien yang diikutsertakan merupakan pasien anak-anak pengguna deferipron n=33 dan deferasirox n=27 yang rutin melakukan transfusi darah pada tahun 2016. Efektivitas pengobatan diukur berdasarkan perubahan kadar serum ferritin. Biaya didapatkan dari median total biaya pengobatan, meliputi biaya obat, alat kesehatan, tindakan, administrasi dan jasa dokter, laboratorium serta kantong darah. Berdasarkan hasil penelitian, deferasirox 1.164 ng/mL lebih efektif dari deferipron 692 ng/mL dan median total biaya pengobatan deferasirox lebih mahal. Hasil akhir menunjukkan bahwa rasio efektivitas-biaya deferasirox Rp 65.816,68 lebih rendah dari deferipron Rp 74.956,60 , namun keduanya tidak ada yang mendominasi sehingga tidak dapat ditentukan terapi yang lebih cost-effective. Bila pengobatan deferipron dipilih, perlu dikeluarkan biaya tambahan sebesar Rp 52.416,64 untuk peningkatan satu unit efektivitas dan pengambil kebijakan di pelayanan kesehatan harus mempertimbangkan apakah biaya lebih tersebut sebanding dengan peningkatan efektivitasnya.

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ABSTRAK
Blood transfusions are needed in improving the quality of life of major thalassemia patients, but it can lead to excess iron, so it requires iron chelation therapy, such as deferiprone and deferasirox. This study is aimed to analyse whether deferipron or deferasirox is more cost effective with Cost Effectiveness Analysis CEA method because each drug has a significant difference in effectiveness and drug costs. Data were taken retrospectively and sampling was done using total sampling based on medical records and hospital information systems. Patients which included are pediatric patients with deferiprone n 33 and deferasirox n 27 who regulary perform blood transfusion in 2016. The effectiveness is measured by changes in serum ferritin levels and the cost is median of the total cost, summed from the cost of drugs, medical devices, hospitalization, administration, physician, laboratories and blood bags. Based on the results, the effectiveness of deferasirox 1,164 ng mL is greater than deferiprone 692 ng mL and median total cost of deferasirox is more expensive. The final result showed that cost effective ratio of deferasirox Rp 65.816,68 is lower than deferiprone Rp 74.956,60 , but none of both medications is dominant and therefore we could not determine which medication is more cost effective. If deferiprone is selected, it requires extra cost Rp 52.416,64 to increase the effectivity. Policy maker in healthcare facility need to consider if incremental cost of medication is equal to its increased effectiveness.