Analisis Efektivitas-Biaya Terapi Kombinasi Metformin-Insulin dan Metformin-Sulfonilurea pada Pasien Rawat Jalan dengan Diabetes Melitus Tipe 2 di RSUPN Dr. Cipto Mangunkusumo

Abstract

Diabetes melitus tipe 2 (DMT2) diketahui sebagai salah satu masalah kesehatan yang memberikan beban ekonomi yang cukup besar pada sistem pelayanan kesehatan di seluruh dunia. Bervariasinya penggunaan terapi obat akan mengakibatkan adanya perbedaan dalam efektivitas dan biaya terapi, sehingga perlu dilakukan analisis efektivitas-biaya. Tujuan dari penelitian ini adalah menganalisis efektivitas-biaya terapi kombinasi metformin-insulin (Met-Ins) dan metformin-sulfonilurea (Met-SU) pada pasien rawat jalan dengan DMT2 berdasarkan perspektif rumah sakit. Penelitian ini menggunakan desain studi kohort, pengambilan data dilakukan secara retrospektif di RSUPN Dr. Cipto Mangunkusumo menggunakan rekam medik pasien rawat jalan dengan DMT2 dan data billing rumah sakit pada periode Januari 2016-Juni 2019. Dilakukan perbandingan efektivitas terapi (∆HbA1c) dan biaya medis langsung antara kedua kelompok. Hasil analisis menunjukkan ∆HbA1c antara kelompok Met-Ins dan kelompok Met-SU tidak memiliki perbedaan yang bermakna secara statistik (rata-rata perbedaan 0,123%; p=0,608). Median biaya medis langsung kelompok Met-Ins lebih tinggi dibandingkan kelompok Met-SU (p<0,001). Hasil analisis efektivitas-biaya menunjukkan bahwa terapi kombinasi Met-SU lebih cost-effective dibandingkan kombinasi Met-Ins.

Cost-Effectiveness Analysis of the Combination of Metformin-Insulin Glargine and Metformin-Glimepiride in Type 2 Diabetes Mellitus Patients in Rupit Hospital

“…This value shows no significant difference in the therapeutic outcome of the two antidiabetic combinations received by the patients. In line with the research conducted by Fitriyani et al (2021), the average difference in the reduction in HbA1c between the metformin-insulin and metformin-sulfonylurea combinations was 0.123%. The results of the compare mean analysis showed a p-value of 0.608, which also meant that there was no significant difference in effectiveness-the significant difference between the two combination therapies 10 .…”

“…In line with the research conducted by Fitriyani et al (2021), the average difference in the reduction in HbA1c between the metformin-insulin and metformin-sulfonylurea combinations was 0.123%. The results of the compare mean analysis showed a p-value of 0.608, which also meant that there was no significant difference in effectiveness-the significant difference between the two combination therapies 10 . However, the results of this study contrast with previous studies, which stated that the metformin-insulin combination therapy had a lower HbA1c value when compared to the metformin-sulfonylurea combination (mean difference = 0.20%; p = 0.1) [18][19][20] .…”

“…The results of the compare mean analysis obtained a pvalue of 0.084, meaning there is no significant difference in the average direct medical costs of the two combination therapies. This value contrasts with the results of a study by Fitriyani et al (2021), which stated that the direct medical costs of the metformininsulin combination (IDR 1,593,427) were greater than those of metformin-sulfonylurea (IDR 922,611). 10 .…”

“…In a previous study, a costeffectiveness analysis was carried out on the https://doi.org/10.30595/jhepr.v1i1.65 ISSN 3025-5198 metformin-insulin and metformin-sulfonylureas combinations. It was found that the metforminsulfonylureas combination therapy was more costeffective than the metformin-insulin combination 10 . The combination of metformin-sulfonylureas with a different mechanism of action is known to improve glycemic control effectively.…”

Analisis Efektivitas Biaya Terapi Kombinasi Insulin dengan Obat Antidiabetes Oral pada Pasien Rawat Jalan Penderita Diabetes Melitus Tipe 2 di RSUD dr. Soehadi Prijonegoro Sragen

“…Biaya medis langsung yang paling banyak terlibat dalam penanganan diabetes diantaranya biaya obat, konsultasi medis, tes laboratorium, komplikasi terkait diabetes jangka panjang. Adanya variasi terapi antidiabetes akan menyebabkan adanya perbedaan harga dan efektivitas terapi [8].…”