Analisis Efektivitas Biaya Penggunaan Obat Antihipertensi pada Pasien Hipertensi dengan Komplikasi Diabetes Melitus Tipe 2 Rawat Inap di RSUP H. Adam Malik Medan

Abstract

Background: BPJS Health data shows that financing for diabetes mellitus increased from IDR84 trillion in 2017 to IDR94 trillion in 2018. One of the complications of type 2 diabetes mellitus is hypertension, where the use of appropriate hypertension drugs is needed for patients with type 2 diabetes mellitus. It is necessary to select antihypertensives with low cost and guarantee the effectiveness of patient therapy. Objective: To analyze the cost effectiveness among antihypertensive therapy models in hypertensive patients with type 2 diabetes mellitus hospitalized at RSUP H. Adam Malik Medan. Methods: The type of research used is a retrospective cohort where data comes from medical records of hypertensive patients with type 2 diabetes mellitus hospitalized at RSUP H. Adam Malik Medan which was financed by BPJS for the period January-December 2023. The Cost Effective Ratio (CER) and Incremental Cost Effective Ratio (ICER) methods were used to analyze the most cost effective antihypertensives. Results: This study 64 patients who met the inclusion criteria were selected as samples. The majority of the participants were female (55%), with the largest proportion of individuals in age group 45-59 years (55%). The CER value in stage 1 hypertension and stage 2 hypertension shows the lowest CER value obtained by Amlodipine 5 mg (IDR. 6.03) and Amlodipine 5 mg + Candesartan 8 mg (IDR. 39.49). Based on ICER, the alternative therapy model used Amlodipine 10 mg + Kandesartan 16 mg + Bisoprolol 2.5 mg required IDR. 54.37 additional costs needed to produce each decrease in blood pressure. Conclusion: The study showed that the most Cost effective of antihypertensive in stage 1 and stage 2 hypertensive patients with type 2 diabetes mellitus is Amlodipine 5 mg and Amlodipine 5 mg + Candesartan 8 mg.