Main Article Content
Abstract
Background: Hypertension followed by type 2 diabetes mellitus is a major risk factor for various cardiovascular diseases and is one of the chronic degenerative diseases Hence, it requires long-lasting treatment therapy and high costs. Based on this, hypertensive patients with DM type 2 need special attention in order to get effective hypertensive therapy at minimum cost. Cost-effectiveness analysis is an analytical method for making decisions on the best alternative to the therapy used. Objectives: To determine the most cost-effective hypertensive therapy in hypertensive patients with DM type 2 diabetes who underwent pharmacoeconomic hospitalization with a cost-effectiveness analysis approach. Methods: This type of study is descriptive observational with a retrospective data collection method from January 2021 - June 2023. The data taken was 31 medical records data and bill fees that met the inclusion criteria. Results: The description of drug use in hypertensive patients with DM type 2 diabetes at RSUD Soehadi Prijonegoro Sragen consists of monotherapy (19.35%) and combination (80.65%). The effectiveness of monotherapy was highest in patients receiving amlodipine therapy (12.42 mmHg), while the effectiveness of the combination was highest in patients taking adalat oros + candesartan + bisoprolol + furosemide + clonidine (22,38 mmHg). From the calculation of the ACER value, it was found that the most cost-effective drug was amlodipine, which had an ACER value of Rp. 289,962 in monotherapy and amlodipine + candesartan with an ACER value of Rp. 262,626. Conclusions: The most widely used hypertension therapy is combination therapy; the drug with the highest effectiveness is adalat oros + candesartan + bisoprolol + furosemide + clonidine and the drug with the highest cost-effectiveness is amlodipine monotherapy and the combination of amlodipine + candesartan.
Keywords
Article Details

This work is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License.
References
- Abraham, G., et al. (2022). Renoprotective role of amlodipine in patients with hypertensive chronic kidney disease. World Journal of Nephrology. Volume 11, No. 3, pp 86–95.
- Ahmad, A., dan Oparil, S. 2017. Hypertension in Women: Recent Advances and Lingering Questions. Hypertension. Volume 70, No 1, pp 19–26.
- Andayani. T.M. 2013. Farmakoekonomi: Prinsip dan Metodologi. Yogyakarta: Bursa Ilmu
- Ansa, D. A., Goenawi, L. R., dan Tjitrosantoso, H. M. 2021. Kajian Penggunaan Obat Antihipertensi pada Pasien Diabetes Melitus Tipe 2 di Instalasi Rawat Inap BLU RSUP Prof. Dr. R. D. Kandou Manado periode Januari-Desember 2010. Jurnal FMIPA UNSRAT Manado. pp 22–26.
- [BPS] Badan Pusat Statistik. 2018. Jumlah Kasus 10 Penyakit Terbanyak di Kota Batu, 2018. bps.go.id. (diakses pada tanggal 20 mei 2023).
- Bani, et al. 2022. The Prevalence of Hypertension and Its Progression among Patients with Type 2 Diabetes in Jordan. Annals of Medicine and Surgery. Volume 73, No. 103162, pp 1-4.
- Bakri, D. F. F., 2017. Analisis Efektivitas Biaya Terapi hipertensi pada Pasien Hipertensi Komplikasi Diabetes Melitus Tipe 2 Rawat Inap Peserta BPJS di RSUD Sukoharjo Tahun 2016 [skripsi]. Surakarta: Program Studi Farmasi Universitas Muhammadiyah Surakarta
- Decroli, E. 2019. Diabetes Mellitus Tipe 2. Padang: Pusat Penerbitan Bagian Ilmu Penyakit Dalam.
- DiPiro, J. T., et al. 2020. Pharmacotherapy: A Pathophysiology Approach, 10th Edition. New York: Mc-Graw Hill Medical.
- Fares, H., DiNicolantonio, J. J., O’Keefe, J. H., dan Lavie, C. J. 2016. Amlodipine in hypertension: A first-line Agent with Efficacy for Improving Blood Pressure and Patient Outcomes. Open Heart. Volume 3 No. 2, pp 1–7.
- Hauser J, M., Azzam, J, S., dan Kasi, A. 2022. Antiemetic Medications. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2023. Available from: https://www.ncbi.nlm.nih.gov/books/NBK532303/
- Hurst, C., Thinkhamrop, C., dan Tran, H.T. 2015. The Association between Hypertension Comorbidity and Microvascular Complications in Type 2 Diabetes Patients : A Nationwide Cross-Sectional Study in Thailand. Diabetes Metabolism Journal. Volume 39, No. 5, pp 395–404.
- Katzung, B, G., dan Trevor, G. J. 2015. Basic & Clinical Pharmacology Thirteenth Edition. San Fransisco: McGraw-Hill Education.
- [KEMENKES RI] Kemenkes RI. 2013. Pedoman Penerapan Kajian Farmakoekonomi. Jakarta; Kementrian Kesehatan RI.
- [KEMENKES RI] Kementrian Kesehatan RI. 2019. Hari Hipertensi Dunia 2019: “Know Your Number, Kendalikan Tekanan Darahmu dengan CERDIK. Diakses pada tanggal 8 juni 2023. https://p2ptm.kemkes.go.id/tag/hari-hipertensi-dunia-2019-know-your-number-kendalikan-tekanan-darahmu-dengan-cerdik
- [KEMENKES RI] Kementerian Kesehatan RI. 2018. Hasil Riset Kesehatan Dasar (Riskesdas) 2018. Jakarta: Badan Penelitian dan Pengembangan Kesehatan Kementerian RI.
- Patel, B. M., dan Mehta, A. A. 2013. Choice of Anti-Hypertensive Agents in Diabetic Subjects. Diabetes and Vascular Disease Research. Volume 10, No. 5, pp 385–396.
- Patel, H. et al s, K. A. 2020. Hypertension in older adults: Assessment, management, and challenges. Clinical Cardiology. Volume 43, No. 2, pp 99–107.
- [PERHI] Perhimpunan Dokter Hipertensi Indonesia. 2019. Konsensus Penatalaksanaan Hipertensi 2019. Jakarta: Indonesian Society Hipertensi Indonesia.
- Petrie, J. R., Tomas, J. G., dan Rhian M. T. 2018. Diabetes, Hypertension, and Cardiovascular Disease: Clinical Insights and Vascular Mechanisms. Canadian Journal of Cardiology. Volume 34, No 5, pp 575–84. doi: 10.1016/j.cjca.2017.12.005.
- Potalangi, S. S., dan Tirayoh. 2014. Penerapan Biaya Relevan Dalam Pengambilan Keputusan Membuat Sendiri Atau Membuat Produk Setengah Jadi Untuk Meningkatkan Laba Pada Cv. Tabea. Jurnal EMBA. Volume 2, No. 2, pp 1251–60.
- Rimoldi, S. F., Messerli, F. H., Chavez, P., Stefanini, G. G., dan Scherrer, U. 2015. Efficacy and Safety of Calcium Channel Blocker/Diuretics Combination Therapy in Hypertensive Patients: A Meta-Analysis. Journal of Clinical Hypertension. Volume 17, No. 3, pp 193–199.
- Rosyidah, K. A., Arina Z. P., Wahid S., and Bintari T. S. 2021. Reformasi Pelayanan Kesehatan Primer pada Puskemas Rawat. Indonesia Jurnal Farmasi. Volume 7, No. 1, pp 52–62.
- Sabrini, A. M., Febrianty, F., dan Shafira, N. N. A. 2022. Karakteristik Pasien DM Tipe 2 dengan Hipertensi Di Poliklinik Penyakit Dalam RSUD Raden Mattaher Jambi Tahun 2016-2019. Joms. Volume 2, No. 2, pp 72–80
- [WHO] World Helath Organization. 2023. Blood pressure/hypertension. Diakses pada tanggal 8 juni 2023. https://www.who.int/data/gho/indicator-metadata-registry/imr-details/3155
- [WHO] World Helath Organization. 2023. Hypertension. Diakses pada tanggal 8 juni 2023. https://www.who.int/news-room/fact-sheets/detail/hypertension
- [WHO] World Helath Organization. 2023. Noncommunicable disease. Diakses pada tanggal 8 juni 2023. https://www.who.int/news-room/fact-sheets/detail/noncommunicable-diseases.