Analisis Efektivitas Biaya (Cost Effectiveness Analysis) Pengobatan Hipertensi pada Pasien Penyakit Gagal Jantung Kongestif Di RSUP. H. Adam Malik Medan

Abstract

Background: Cardiovascular diseases represented the most significant portion of catastrophic healthcare expenditure, comprising 49% of total Social Security Agency on Health claims. Of the total Rp 20 trillion in catastrophic costs, approximately Rp 9.8 trillion was allocated by Social Security Agency on Health for the provision of healthcare services to JKN- KIS enrollees diagnosed with heart diseases, encompassing 12.9 million cases. Objective: The objective of this study is to determine the single and combination antihypertensive regimens, as well as the cost-effectiveness of these treatments, among hospitalized patients with congestive heart failure at H. Adam Malik General Hospital, Medan. Methods: This study is a non-experimental research aimed at analyzing the cost-effectiveness of outpatient congestive heart failure treatment at H. Adam Malik Hospital, Medan, from the hospital's perspective, based on the CER and ICER values. Result: The results showed that Congestive Heart Failure (CHD) patients had single and combined hypertension therapy models with the following percentages CCB + ACEI + Diuretics (25%), BB + Diuretics +ARB (13%), CCB +ACEI + Diuretics +ARB (11%), CCB + Diuretics (11%), Diuretics (9%), CCB +BB +ARB (9%), ACEI +BB + Diuretics (9%), CCB + Diuretics +ARB (6%), CCB +BB + Diuretics +ARB (6%). According to CER and ICER calculations, the most cost-effective antihypertensive therapy model is CCB + Diuretics therapy with a CER of Rp. 2,706.03 with an ICER of -Rp. 9,789.48. Conclusion: The results showed on CER and ICER calculations, the most cost-effective antihypertensive therapy model is CCB + Diuretics.