The Availability of Antihypertensive Drug in Era of Nhi: A Study in the Primary Health Care Centre Jakarta-Indonesia

Abstract

Objective: The study was carried out to observe the impact of NHI to availability, usage, stock of antihypertensive drug enrolled in a national formulary in one of the primary health care centre in Jakarta. 
 Methods: A longitudinal time series design was performed retrospectively to analyse the availability, usage, and stock of antihypertensive drug. The data period was from January 2013 (1 y before NHI) to December 2015 (2 y after NHI). The Independent-Samples T or Mann-Whitney test was conducted to compare these parameters before and after NHI.
 Results: We found amlodipine 5 mg and 10 mg tablet, hydrochlorothiazide 25 mg tablet, captopril 12.5 mg and 25 mg tablet, nifedipine 10 mg tablet were available in Primary Health Care. These drug were generic and tablet dosage form. The most common drug used was captopril and Nifedipine, respectively. The highest availability was diuretic hydrochlorothiazide. The availability of amlodipine 5 mg and 10 mg tablet, captopril 12.5 mg tablet increased significantly (P<0.05) after NHI was implemented. Moreover, hydrochlorothiazide decreased (P<0.05) as well. The usage of amlodipine and hydrochlorothiazide risen (P<0.05) but the nifedipine decreased (P<0.05) after NHI. All stock of antihypertensive except captopril 25 mg different significantly (P<0.05) after the application of NHI.
 Conclusion: This study highlights the implementation of NHI impacted the availability, usage, and stock of antihypertensive drug enrolled in national formulary.

Factors associated with the availability and affordability of essential cardiovascular disease medicines in low- and middle-income countries: A systematic review

“…Risk of bias assessment revealed heterogeneity in the quality of the included studies. Fifteen of the cross-sectional studies had one or more domains with high risk of bias [23,24,27,32,35,37,43,[49][50][51][52][53][54][55]57] while another seven had unclear risk of bias in at least one domain [20,22,30,44,53,54,59]. Detailed characteristics of included studies and the results of risk of bias assessments are described in Table 2.…”

“…Health sector (program) level. Eight studies examined health sector level arrangements [20,26,28,35,42,44,54,56]. Three studies from Brazil, China, and Nigeria all point to an association between facility revenues and medicine availability [26,35,44].…”

“…In a fourth study, from Indonesia, implementation of a national policy that included a shift from fee-for-service to more limited reimbursements based on the type of diagnosis was associated with variable results for different types of antihypertensive agents. This policy also included a requirement that medicines be ordered from the national formulary, however, the study provided little detail on the methodology employed [54].…”