Gagal jantung merupakan masalah kesehatan yang progresif dengan angka mortalitas dan morbiditas yang tinggi di negara maju maupun negara berkembang termasuk Indonesia. Banyak pilihan yang dapat diberikan kepada pasien gagal jantung, salah satu contohnya adalah kombinasi ramipril-bisoprolol dan kandesartan-bisoprolol. Tujuan penelitian ini adalah menganalisis minimalisasi biaya antara kelompok terapi kombinasi ramipril-bisoprolol dan kandesartan-bisoprolol pada pasien BPJS rawat inap gagal jantung di RSJPD Harapan Kita tahun 2017. Penelitian ini merupakan penelitian cross-sectional dengan pengambilan data secara retrospektif terhadap rekam medis, resep dan sistem informasi rumah sakit. Pengambilan sampel dilakukan secara total sampling di Rumah Sakit Jantung dan Pembuluh Darah Harapan Kita. Efektivitas pengobatan diukur berdasarkan penurunan tekanan darah sistol dan diastol yang diasumsikan sama. Biaya didapatkan dari median total biaya pengobatan, meliputi biaya obat gagal jantung, obat non-gagal jantung, rawat inap, pemeriksaan penunjang dan jasa dokter. Sampel pada penelitian ini berjumlah 65 pasien, yaitu 37 pasien terapi kombinasi ramipril-bisoprolol dan 28 pasien terapi kombinasi kandesartan-bisoprolol. Median total biaya pengobatan kelompok terapi kombinasi ramipril-bisoprolol Rp 7.391.584,00 lebih mahal dibandingkan dengan kelompok terapi kombinasi kandesartan-bisoprolol Rp 7.061.533,00, terdapat selisih sebesar Rp 330.051,00. Analisis sensitivitas satu arah/-25 dilakukan untuk mengetahui kekuatan dari evaluasi ekonomi melalui perubahan terhadap hasil penelitian. Oleh karena itu, dapat disimpulkan bahwa kelompok terapi kombinasi kandesartan-bisoprolol lebih cost-minimal dibandingkan kelompok terapi kombinasi ramipril-bisoprolol dengan efektivitas yang setara.
Heart failure is a progressive health problem with high mortality and morbidity in both developed and developing countries including Indonesia. Many options can be given to patients with heart failure, one example is a combination of ramipril bisoprolol and candesartan bisoprolol. The aim of this study was to analyze cost minimization between the combination therapy group of ramipril bisoprolol and candesartan bisoprolol in BPJS hospitalized patients with heart failure. This research was a cross sectional study with retrospective data retrieval on medical record, prescriptions, and hospital rsquo s information system. Sampling was done by total sampling. The effectiveness of treatment was measured by the decrease in systolic and diastolic blood pressure that was assumed to be the same. Cost was obtained from the median total cost of treatment, including the cost of heart failure drugs, non heart failure drugs, hospitalization, laboratorium and physician services. The sample in this study amounted to 65 patients, 37 patients from combination therapy ramipril bisoprolol and 28 patients from combination therapy candesartan bisoprolol. Based on the results of the study, the median total cost of treatment of Ramipril group Rp 7,391,584.00 was more expensive compared with the candesartan group Rp 7.061.533,00 , there was a difference of Rp 330,051.00. One way sensitivity analysis 25 was performed to determine the strength of the economic evaluation through changes to the research results. Therefore, it can be concluded that the candesartan therapy group is more cost minimal than the ramipril therapy group with equal effectiveness. |
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