COST-EFFECTIVENESS ANALYSIS OF COMBINATION ANTIHYPERTENSIVE DRUG ON HYPERTENSION OUTPATIENTS AT RSUD KABUPATEN KARANGANYAR 2020

Abstract

Hypertension is the leading risk factor for myocardial infarction, stroke, acute renal failure, and death. Hypertension is one of the ten most common diseases at the RSUD Kabupaten Karanganyar. Antihypertensive drugs in RSUD Kabupaten Karanganyar that are often used are Herbesser (diltiazem HCl), candesartan, and ramipril. This research aimed to compare cost-effective combination antihypertensive (Herbesser-candesartan and Herbesser-ramipril) for outpatients at RSUD Karanganyar in 2020. The subjects were 84 outpatients who received combination antihypertensive (Herbesser – candesartan and Herbesser – ramipril). Therapeutics outcome saw from normal blood pressure at the next consultation, collected from patient medical records. The medical expenses were calculated from direct medical costs written in billing invoices based on a payer perspective. Cost-effectiveness analysis was performed by calculating the Average Cost-Effectiveness Ratio (ACER) and Incremental Cost-Effectiveness Ratio (ICER). The results showed that the combination of Herbesser – ramipril was more effective (83%) than Herbesser – candesartan (79%). The average direct medical cost of the Herbesser – candesartan was IDR 743,852, and Herbesser – ramipril was IDR 868,855. In addition, the combination drug of Herbesser – candesartan was more cost-effective (ACER IDR 942,213 per percent activity) than Herbesser – ramipril (ACER IDR 1.046.813 per percent activity) with an ICER value of IDR 31,250 per percent activity. In conclusion, the combination Herbesser-candesartan is a cost-effective medication for hypertension outpatients at RSUD Kabupaten Karanganyar in 2020.