ANALISIS FARMAKOEKONOMI PENGGUNAAN AMLODIPIN, KOMBINASI AMLODIPIN/VALSARTAN, DAN KOMBINASI AMLODIPIN/TELMISARTAN PADA PASIEN PENYAKIT GINJAL DIABETIK DI RUANG RAWAT INAP LONTARA RSUP DR WAHIDIN SUDIROHUSODO
Keywords:
Efektivitas Biaya, Minimalisasi Biaya, Hipertensi, Penyakit Ginjal Diabetik, Amlodipin, Kombinasi Amlodipin Valsartan, Kombinasi Amlodipin TelmisartanAbstract
Penyakit ginjal diabetik (PGD) merupakan komplikasi mikrovaskular dari diabetes, yang dapat
mengakibatkan end-stage renal disease. Manajemen pengobatan hipertensi pada pasien penyakit
ginjal diabetik memberikan kontribusi yang cukup signifikan terhadap penurunan risiko morbiditas dan
mortalitas kardiovaskular, serta menghambat perkembangan kerusakan ginjal. Penelitian ini
merupakan penelitian observasional analitik dengan pendekatan kohort retrospektif dan prospektif
menggunakan studi perbandingan (comparative study) yang bertujuan untuk mendapatkan
perbandingan biaya minimal, dan efektivitas-biaya antara penggunaan amlodipin, kombinasi
amlodipin/valsartan dan kombinasi amlodipin/telmisartan pada pasien hipertensi dengan penyakit
ginjal diabetik di instalasi rawat inap Lontara 1 RSUP dr. Wahidin Sudirohusodo Makassar periode bulan
Juli sampai Desember 2019. Hasil penelitian menunjukkan bahwa rerata biaya kelompok amlodipin
lebih rendah dibandingkan kelompok lainnya. Penggunaan amlodipin tunggal memiliki biaya yang lebih
rendah dibandingkan kelompok kombinasi amlodipin/valsartan dan kombinasi amlodipin/telmisartan
dengan total rerata biaya yaitu Rp 2.178.758. Penggunaan amlodipin tunggal memiliki efektivitas-biaya
yang lebih baik dibandingkan kelompok kombinasi amlodipin/valsartan dan kelompok kombinasi
amlodipin/telmisartan pada penyakit ginjal diabetik, yaitu dengan nilai REB Rp 74.082 per 1 mmHg TDS
dan Rp 162.109 per 1 mmHg TDD. Sehingga dapat disimpulkan penggunaan amlodipin merupakan
terapi yang direkomendasikan untuk pengobatan hipertensi dengan penyakit ginjal diabetik secara
efektivitas-biaya serta merupakan kelompok terapi yang biayanya paling rendah untuk pengobatan
hipertensi dengan penyakit ginjal diabetik.
References
UK Prospective Diabetes Study Group. Tight blood pressure control and risk of macrovascular and microvascular complications in type 2 diabetes: UKPDS 38. UK Prospective Diabetes Study Group. BMJ. 1998 Sep 12;317(7160):703-13. Erratum in: BMJ 1999 Jan 2;318(7175):29. PMID: 9732337; PMCID: PMC28659.
Panagiotis I. Georgianos and Agarwal ,Rajiv. Pharmacotherapy of Hypertension in Chronic Dialysis Patients. CJASN November 2016, 11 (11) 2062-2075; DOI: https://doi.org/10.2215/CJN.00870116
Reboussin DM, Allen NB, Griswold ME, Guallar E, Hong Y, Lackland DT, Miller EPR 3rd, Polonsky T, Thompson-Paul AM, Vupputuri S. Systematic Review for the 2017 ACC/AHA/AAPA/ABC/ACPM/AGS/APhA/ASH/ASPC/NMA/PCNA Guideline for the Prevention, Detection, Evaluation, and Management of High Blood Pressure in Adults: A Report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines. Hypertension. 2018 Jun;71(6):e116-e135. doi: 10.1161/HYP.0000000000000067. Epub 2017 Nov 13. Erratum in: Hypertension. 2018 Jun;71(6):e145. PMID: 29133355.
Zhou, Guangyu & Cheung, Alfred & Liu, Xia & Huang, Yufeng. (2013). Valsartan slows the progression of diabetic nephropathy in db/db mice via reduction in podocyte injury and renal oxidative stress and inflammation.. Clinical science (London, England : 1979). 126. 10.1042/CS20130223.
Patney, Vikram et al. “Hypertension Management in Diabetic Kidney Disease.” Diabetes spectrum : a publication of the American Diabetes Association vol. 28,3 (2015): 175-80. doi:10.2337/diaspect.28.3.175
Gattani SG, AB Patil, SS Kushare. Pharmacoeconomic: A Review. Asian Journal of Pharmaceutical and Clinical Reseach. 2009;2(3):15-26.
Rascati KL. Essentials of Pharmacoeconomics. 2th ed. Philadelphia: Lippincott Williams & Wilkies. 2014.
Badan Penelitian dan Pengembangan Kesehatan. Riset Kesehatan Dasar Riskesdas 2018. Jakarta: Kementerian Kesehatan RI. 2018.
Rascati KL. Essentials of Pharmacoeconomics. 2th ed. Philadelphia: Lippincott Williams & Wilkies. 2014.
Departemen Kesehatan Republik Indonesia, Bina Pelayanan Kefarmasian. Pedoman Penerapan Kajian Farmakoekonomi. Kemenetrian Kesehatan Republik Indonesia. Jakarta. 2013.
Bosworth, H. B., Siegler, I. C., Olsen, M. K., Brummett, B. H., Barefoot, J. C., Williams, R. B.,&. Mark, D. B. (2001). Social support and quality of life in patients with coronary artery disease. Quality of Life Research, 9(7), 829-839.
Bekki, H, et al. 2010. Efficacy of Combination Therapy with Telmisartan plus Amlodipin in Patients with Poorly Controlled Hypertension. Oxydative Medicine and Cellular Longevity. 3:5. 342-346.
Goyal J, Khan ZY, Upadhyaya P, Goyal B, Jain S. Comparative study of high dose mono-therapy of amlodipine or telmisartan, and their low dose combination in mild to moderate hypertension. J Clin Diagn Res. 2014 Jun;8(6):HC08-11. doi: 10.7860/JCDR/2014/9352.4500. Epub 2014 Jun 20. PMID: 25121000; PMCID: PMC4129356.
Billecke, SS dan Marcovitz PA. Long-term Safety and Efficacy of Telmisartan/Amlodipin singke Pill Combination in the Treatment of Hypertension. Vascular Health and Risk Management. 2013; 9:95-104.
Bootman J.L., Townsend R.J. and Mcghan W.F. 1996. Introduction to Pharmacoeconomics. Dalam Principles of Pharmacoeconomics. United State of America : Harvey Whitney Books Company.
Carvalho VM, Siqueira BL, Sousa LL, Jardim VB. The influence of hypertension on quality of life. Arq Bras Cardiol. 2013; 100(2):164–4.
Miura S and Saku S. 2012. Efficacy and Safety of Angiotensin II Type 1 Receptor Blocker/Calcium Channel Blocker Combination Therapy for Hypertension: Focus on a Single-pill Fixed-dose Combination of Valsartan and Amlodipine. The Journal of International Medical Research. 2012; 40: 1 – 9.
Downloads
Published
Issue
Section
License
Copyright (c) 2021 Majalah Farmasi dan Farmakologi
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
The copyright to this article is transferred to Universitas Hasanuddin (UNHAS) if and when the article is accepted for publication. The undersigned hereby transfers all rights in and to the paper including without limitation all copyrights to UNHAS. The undersigned hereby represents and warrants that the paper is original and that he/she is the author of the paper, except for material that is clearly identified as to its original source, with permission notices from the copyright owners where required. The undersigned represents that he/she has the power and authority to make and execute this assignment.
We declare that:
- This paper has not been published in the same form elsewhere.
- It will not be submitted anywhere else for publication prior to acceptance/rejection by this Journal.
- A copyright permission is obtained for materials published elsewhere and which require this permission for reproduction.
Furthermore, I/We hereby transfer the unlimited rights of publication of the above-mentioned paper in whole to UNHAS The copyright transfer covers the exclusive right to reproduce and distribute the article, including reprints, translations, photographic reproductions, microform, electronic form (offline, online) or any other reproductions of similar nature.
The corresponding author signs for and accepts responsibility for releasing this material on behalf of any and all co-authors. This agreement is to be signed by at least one of the authors who have obtained the assent of the co-author(s) where applicable. After submission of this agreement signed by the corresponding author, changes of authorship or in the order of the authors listed will not be accepted.
