Paper Title
Cost Effectiveness Analysis of Antihypertensive Drugsusage by Combination of Acei–Ccb and Arb-Ccb in Outpatient at Rsud Gunung Jati Cirebon 2014
Abstract
Currently, cases of hypertension are increasing not only in Indonesia but also in the world. This disease is usually without symptoms and signs so it is often called a silent killer diseases. The objectiveof study was to determine the effectiveness and efficiency of the use of ACEI-CCB and ARB-CCB antihypertensive drugs in the treatment of hypertensiveoutpatients in GunungJati Hospital Cirebon. Methods, This study was a cohort design to determine the effectiveness of the two groups of antihypertensive drugs and to measure cost efficiency using method the Pharmacoeconomic Cost Effectiveness Analysis. The sample size in this study 66 hypertensive patients were collected from the medical records of hypertensive patients who met the inclusion and exclusion criteria. Then the sample was divided into 2 groups, Group A 33 patients who received ACEI-CCB and Group B 33 patients who received ARB-CCB. Data collection was carried out prospectively for hypertensive patients who are on outpatient treatment and use combination antihypertensive drugs that are same for both groups of patients for three months according to JNC 8.Antihypertensive effectiveness was measured by counting the number of patients whose blood pressure was controlled (<140 / 90mmHg) and <130/80 mmHg in patients with diabetes mellitus. Resultsshowed that the most controlled blood pressure was found in the ACEI-CCB combination was 72.7%, while the ARB-CCB in the controlled blood pressure was 61.8%. It showed that the ACEI-CCB wasmore effective than the ARB-CCB. ACEI-CCB Unit Cost was IDR 627,299.72 (ACER), while ARB-CCB unit cost was IDR 1,606,219.81. This means that the antihypertensive combination of ACEI-CCB unit cost was lower than the ARB-CCB. ACEI-CCB was more effective than the ARB-CCB, characterized by a lower ACER valuethan ARB-CCB and ICER value was IDR -211,910. Conclusion, ACEI-CCB combination is more effective compared to the ARB-CCB and the ACEI-CCB combination is more efficient than the ARB-CCB.
Keywords - Hypertension, Antihypertensive drugs combination ACEI (Angiotensin Comperting Enzym Inhibitor ) –CCB(Calcium Chanel Blocker),ARB(Angiotensin Receptor Blocker) –CCB (Cost Effectiveness Analysis, ACER(Average Cost Effectiveness Ratio), ICER (Incremental Cost Effectiveness Ratio)