COST AND EFFECTIVENESS ANALYSIS FOR THE USAGE OF ANTIHYPERTENSIVE AND ANTIDISLIPIDEMIA IN ONE OF PRIVATE HOSPITAL IN BANDUNG

• Main Author: Susanti B, Mesrani
• Format: Final Project
• Language: Indonesia
• Online Access: https://digilib.itb.ac.id/gdl/view/62169
• Institution: Institut Teknologi Bandung

The risk of hypertension increases with age, unhealthy lifestyle, smoking, diet, and stress. Dyslipidemia is often associated with one of the causes of hypertension that can affect the heart's activity. This study was conducted to compare several combinations of antihypertensive and antidislipidemia, to obtain the cost-effectiveness of each combination and to determine the most effective antihypertensive and antidislipidemia drug combinations to treat the patient's disease. This research was a pharmacoeconomic study by using the cost-effectiveness method, which has been done retrospectively in hospitalized patients who were given antihypertensive and antidislipidemia drugs in one of the private hospital in Bandung during the period of September until December 2012. In ICER analysis (Incremental Cost Effectiveness Ratio), antihypertensives that have been used in the comparison were CCB (Calcium Channel Blocker), ACE (Angiotensin Converting Enzyme) inhibitor, ARB (Angiotensin Receptor Blocker), diuretics, and ?blocker. Based on ICER analysis, the most cost effective antihypertensive was CCB. The effect of CCB in reducing blood pressure was better than other types of antihypertensive with a lower cost. The ICER value of this comparison was located in quadrant II. For antidislipidemia, inhibitor HMG Co-A reductase (statins) has been compared to fibric acid. Based on that comparison, statins was more cost effective than fibric acid, with an ICER value located in quadrant II. However, the reduction of triglycerides level of statins was lower than fibric acid, with lower cost. The value of ICER was located in quadrant III. For the combination of antihypertensive and antidislipidemia, there were several combinations that have been used in the comparison of antihypertensive-antidislipidemia combination. They were CCB-statins, ARB-statins, ACE inhibitor-statins, diuretics-statins, ?blocker-statins, and CCB-ARB-statins. Based on ICER analysis, combination of CCB-statins was more cost effective than the combination of ARB-statins in reducing blood pressure and triglycerides level. The value of the ICER was –Rp 27,342,00 for systole, -Rp 339,858,00 for diastole, and –Rp 31,195,00 for triglycerides, located in quadrant II. In addition, CCB-statins combination was also more cost effective than ACE inhibitor-statins, diuretics-statins and ?blocker-statins, with an ICER value located in quadrant II as well. However, the reduction of total cholesterol of CCB-statins combination was lower than ARB-statins, ACE inh-statins, and ARB-CCBstatins, although with a lower cost. In addition, the raising of HDL (High Density Lipoprotein) level was lower than ?blocker-statins combination and the reduction of LDL (Low Density Lipoprotein) level was lower than ARB-CCB-statins, although with a lower cost. The most cost-effective antihypertensive was CCB, and the most cost-effective antidislipidemia was statins. Meanwhile, the most cost-effective antihypertensive and antidislipidemia combination based on ICER analysis was CCB-statins combination.