scholarly journals Cost Effectiveness Kombinasi Antihipertensi Candesartan-Bisoprolol dan Candesartan-Amlodipin Pada Pasien Rawat Jalan Penderita Hipertensi

2019 ◽  
Vol 13 (2) ◽  
Author(s):  
Eny Nurhikma ◽  
Randa Wulaisfan ◽  
Musdalipah Musdalipah
Keyword(s):  
Cost Effectiveness ◽  
Average Cost ◽  
Cross Sectional Study ◽  
Cost Effectiveness Analysis ◽  
Sectional Study ◽  
Cost Effectiveness Ratio ◽  
Cross Sectional ◽  
Hypertensive Patients ◽  
Effectiveness Analysis ◽  
The Cost

Today, in various countries, especially in Indonesia, the cost of health services is increasing. Hypertension is a degenerative disease that requires health costs for a long time. Increasing costs due to increasing chronic diseases threaten access and quality of health services, by which it is necessary to find a solution to overcome the problem of health financing. One method used is to analyze the guidelines for hypertension therapy and drug classes in the pharmacoeconomic aspects, namely Cost Effectiveness Analysis. This study aims to analyze the effectiveness of antihypertensive combination therapy in hypertensive patients at Bhayangkara Hospital, Kendari in 2019. The research method is descriptive with cross sectional study design. The analysis conducted is the cost effectiveness analysis (CEA) performed by calculating direct medical costs, the effectiveness of therapy based on blood pressure that reaches the target and calculating the value of ACER (Average Cost Effectiveness Ratio) and ICER (Incremenal Cost Effectiveness Ratio). Data were collected prospectively which fulfilled the inclusion and exclusion criteria. The results showed the therapeutic effectiveness and the value of ACER obtained from 31 hypertensive patients were a combination of Candesartan – Bisoprolol  that was ACER value of 85.71% (2,314), and combination of Candesartan – Amlodipin of 70.58% (2,643). ICER value of 7,832 indicates that the price of drugs is more expensive but more effective therapy.Keywords : cost effective, ACER, ICER, Hypertension, Candesartan, Amlodipin Abstrak: Dewasa ini, diberbagai negara khususnya di Indonesia biaya pelayanan kesehatan semakin meningkat. Hipertensi merupakan salah satu penyakit degeneratif yang membutuhkan biaya kesehatan dalam jangka waktu yang lama. Peningkatan biaya akibat semakin meningkatnya penyakit kronik mengancam akses dan mutu pelayanan kesehatan, olehnya itu perlu dicari solusi untuk mengatasi masalah pembiayaan kesehatan. Salah satu metode yang dilakukan yaitu dengan menganalisis pedoman terapi hipertensi dan golongan obat dalam aspek farmakoekonomi, yaitu Analisis Efektivitas Biaya. Penelitian ini bertujuan untuk menganalisis efektivitas terapi kombinasi antihipertensi pada pasien hipertensi di Rumah Sakit Bhayangkara Kendari tahun 2019. Metode penelitian ialah deskriptif dengan rancangan cross sectional study. Data diambil secara prospektif yang memenuhi kriteria inklusi dan eksklusi. Analisis yang dilakukan adalah cost effectiveness analysis (CEA) dilakukan dengan menghitung biaya medik langsung, efektivitas terapi berdasarkan tekanan darah yang mencapai target dan menghitung nilai ACER (Average Cost Effectiveness Ratio) dan ICER (Incremenal Cost Effectiveness Ratio). Hasil penelitian menunjukkan efektifitas terapi dan nilai ACER yang diperoleh dari 31 pasien hipertensi ialah kombinasi Candesartan – Bisoprolol  yaitu nilai ACER sebesar 85,71%  (2.314), dan kombinasi Candesartan – Amlodipin  sebesar 70,58% (2.643). Nilai ICER  sebesar 7.832 menunjukkan bahwa harga obat lebih mahal namun terapi lebih efektif. Kata Kunci : Efektivitas biaya, ACER, ICER, Hipertensi, Candesartan, Amlodipin

Cost-effectiveness Analysis of Submandibular Gland Preservation With Sialendoscopy for the Management of Sialolithiasis

2021 ◽  
pp. 019459982110268
Author(s):  
Joseph R. Acevedo ◽  
Ashley C. Hsu ◽  
Jeffrey C. Yu ◽  
Dale H. Rice ◽  
Daniel I. Kwon ◽  
...  
Keyword(s):  
Cost Effectiveness ◽  
Submandibular Gland ◽  
Average Cost ◽  
Cost Effective ◽  
Cost Effectiveness Analysis ◽  
Effectiveness Analysis ◽  
Life Years ◽  
Probability Of Success ◽  
Markov Decision Model ◽  
The Cost

Objective To compare the cost-effectiveness of sialendoscopy with gland excision for the management of submandibular gland sialolithiasis. Study Design Cost-effectiveness analysis. Setting Outpatient surgery centers. Methods A Markov decision model compared the cost-effectiveness of sialendoscopy versus gland excision for managing submandibular gland sialolithiasis. Surgical outcome probabilities were found in the primary literature. The quality of life of patients was represented by health utilities, and costs were estimated from a third-party payer’s perspective. The effectiveness of each intervention was measured in quality-adjusted life-years (QALYs). The incremental costs and effectiveness of each intervention were compared, and a willingness-to-pay ratio of $150,000 per QALY was considered cost-effective. One-way, multivariate, and probabilistic sensitivity analyses were performed to challenge model conclusions. Results Over 10 years, sialendoscopy yielded 9.00 QALYs at an average cost of $8306, while gland excision produced 8.94 QALYs at an average cost of $6103. The ICER for sialendoscopy was $36,717 per QALY gained, making sialendoscopy cost-effective by our best estimates. The model was sensitive to the probability of success and the cost of sialendoscopy. Sialendoscopy must meet a probability-of-success threshold of 0.61 (61%) and cost ≤$11,996 to remain cost-effective. A Monte Carlo simulation revealed sialendoscopy to be cost-effective 60% of the time. Conclusion Sialendoscopy appears to be a cost-effective management strategy for sialolithiasis of the submandibular gland when certain thresholds are maintained. Further studies elucidating the clinical factors that determine successful sialendoscopy may be aided by these thresholds as well as future comparisons of novel technology.

scholarly journals Cross-sectional study of prevalence and risk factors, and a cost-effectiveness evaluation of screening and preventive treatment strategies for latent tuberculosis among migrants in Singapore

BMJ Open ◽  
2021 ◽  
Vol 11 (7) ◽  
pp. e050629
Author(s):  
Vanessa W Lim ◽  
Hwee Lin Wee ◽  
Phoebe Lee ◽  
Yijun Lin ◽  
Yi Roe Tan ◽  
...  
Keyword(s):  
Risk Factors ◽  
Cost Effectiveness ◽  
Length Of Stay ◽  
Latent Tuberculosis ◽  
Cross Sectional Study ◽  
Secondary Outcome ◽  
Sectional Study ◽  
Cross Sectional ◽  
Ltbi Prevalence ◽  
The Cost

ObjectivesWHO recommends that low burden countries consider systematic screening and treatment of latent tuberculosis infection (LTBI) in migrants from high incidence countries. We aimed to determine LTBI prevalence and risk factors and evaluate cost-effectiveness of screening and treating LTBI in migrants to Singapore from a government payer perspective.DesignCross-sectional study and cost-effectiveness analysis.SettingMigrants in Singapore.Participants3618 migrants who were between 20 and 50 years old, have not worked in Singapore previously and stayed in Singapore for less than a year were recruited.Primary and secondary outcome measuresCosts, quality-adjusted life-years (QALYs), threshold length of stay, incremental cost-effectiveness ratios (ICERs), cost per active TB case averted.ResultsOf 3584 migrants surveyed, 20.4% had positive interferon-gamma release assay (IGRA) results, with the highest positivity in Filipinos (33.2%). Higher LTBI prevalence was significantly associated with age, marital status and past TB exposure. The cost-effectiveness model projected an ICER of S$57 116 per QALY and S$12 422 per active TB case averted for screening and treating LTBI with 3 months once weekly isoniazid and rifapentine combination regimen treatment compared with no screening over a 50-year time horizon. ICER was most sensitive to the cohort’s length of stay in Singapore, yearly disease progression rates from LTBI to active TB, followed by the cost of IGRA testing.ConclusionsFor LTBI screening and treatment of migrants to be cost-effective, migrants from high burden countries would have to stay in Singapore for ~50 years. Risk-stratified approaches based on projected length of stay and country of origin and/or age group can be considered.

scholarly journals Costs of reusable and disposable aprons in a public teaching hospital

2014 ◽  
Vol 48 (5) ◽  
pp. 915-921
Author(s):  
Paloma de Souza Cavalcante Pissinati ◽  
Maria do Carmo Lourenço Haddad ◽  
Mariana Ângela Rossaneis ◽  
Roseli Broggi Gil ◽  
Renata Aparecida Belei
Keyword(s):  
Direct Cost ◽  
Teaching Hospital ◽  
Average Cost ◽  
Secondary Data ◽  
Cross Sectional Study ◽  
Sectional Study ◽  
Cross Sectional ◽  
Hospital Managers ◽  
Study Population ◽  
The Cost

Objective To analyze the direct cost of reusable and disposable aprons in a public teaching hospital. Method Cross-sectional study of quantitative approach, focusing on the direct cost of reusable and disposable aprons at a teaching hospital in northern Paraná. The study population consisted of secondary data collected in reports of the cost of services, laundry, materials and supplies division of the institution for the year 2012 Results We identified a lower average cost of using disposable apron when compared to the reusable apron. The direct cost of reusable apron was R$ 3.06, and the steps of preparation and washing were mainly responsible for the high cost, and disposable apron cost was R$ 0.94. Conclusion The results presented are important for hospital managers properly allocate resources and manage costs in hospitals
.

scholarly journals ANALISIS EFEKTIVITAS BIAYA (COST EFFECTIVENESS ANALYSIS) PENGOBATAN INFEKSI SALURAN KEMIH MENGGUNAKAN ANTIBIOTIK SEFTRIAKSON DAN SEFOTAKSIM DI RS PARU ARIO WIRAWAN SALATIGA

2019 ◽  
Vol 1 (1) ◽  
pp. 20-26
Author(s):  
Kusumaning Wardhani ◽  
Ening Listyanti ◽  
Niken Dyahariesti ◽  
Richa Yuswantina
Keyword(s):  
Cost Effectiveness ◽  
Incremental Cost ◽  
Average Cost ◽  
Cost Effective ◽  
Cost Effectiveness Analysis ◽  
Cost Effectiveness Ratio ◽  
Effectiveness Analysis

Infeksi Saluran Kemih (ISK) adalah keadaan dimana kuman bertumbuh dan berkembangbiak di dalam traktus urinarius dengan jumlah yang bermakna. ISK diobati dengan antibiotik yang menjadi salah satu kategori biaya yang signifikan dalam anggaran farmasi di rumah sakit. Antibiotik golongan Sefalosporin digunakan sebagai drug of choise dan dicari lebih cost-effective. Untuk menentukan terapi yang lebih cost-effective antara penggunaan Setriakson dan Sefotaksim pada pasien ISK di rawat inap di RS Paru Ario Wirawan Salatiga. Penelitian ini menggunakan metode penelitian deskriptif dengan pengambilan data secara retrospektif.Dianalisis dengan metode CEA dengan parameter Average Cost Effectiveness Ratio (ACER) dan Incremental Cost Effectiviness Ratio (ICER) dilihat dari outcome lama rawat inap. Sampel pada penelitian ini sebanyak 39 pasien diantaranya 22 pasien menggunakan Seftriakson dan 17 pasien menggunakan Sefotaksim. Hasil penelitian menunjukkan, nilai ACER kelas I Sefotaksim sebesar Rp. 454.353. Nilai ACER kelas II Sefotaksim sebesar Rp. 212.283 dan nilai ICER sebesar -Rp. 134.987/hari. Nilai ACER kelas III Seftriakson sebesar Rp. 268.366. Biaya antibiotik yang paling cost-effective pada kelas I adalah Sefotaksim, paling cost-effective pada kelas II adalah Sefotaksim, paling cost-effective pada kelas III adalah Seftriakson.

scholarly journals Analisis Efektivitas Biaya Terhadap Penggunaan Meropenem dan Tanpa Hasil Uji Sensitivitas Antibiotik pada Pasien Gagal Ginjal Kronik di Rumah Sakit

2019 ◽  
Vol 47 (2) ◽  
pp. 125-134
Author(s):  
Lukman Prayitno ◽  
Selma Siahaan ◽  
Rini Sasanti Handayani
Keyword(s):  
Cost Effectiveness ◽  
Average Cost ◽  
Antibiotic Sensitivity ◽  
Secondary Data ◽  
Sensitivity Test ◽  
Cost Effectiveness Ratio ◽  
Sensitivity Testing ◽  
Cross Sectional ◽  
Antibiotic Sensitivity Test ◽  
The Cost

Introduction: The prevalence of chronic kidney disease (CKD) is quite high. The use of meropenem needs attention. Meropenem is an expensive third generation antibiotic. It increase the cost of treatment If it uses irrationally. There is also a danger of resistance that impact to the difficulty of treatment. Therefore a study was conducted on "Cost Effectiveness Analysis between the Use of Meropenem with and without Antibiotic Sensitivity Test Results in CKD Patients in Hospitals". Methode: research methode is cross sectional. The hospital was chosen directly from two city : Manado and Semarang. The data was secondary data that meet with inclusion and exclusion criteria fram patient's medical record and medical expenses in 2016. Data collection tools were forms. Results: Cases of CKD that fulfilled were 29 from Hospital X, 11 cases with sensitivity and 18 cases without sensitivity testing. In Hospital Y there were 20 cases, 17 cases with sensitivity test and 3 cases without sensitivity test. At Hospital X, the value of the Average Cost Effectiveness Ratio (ACER) with a sensitivity test was 94,242,994 rupiah and the ACER value without sensitivity testing was 142,793,491 rupiah. In the Y Hospital it is not comparable because 85% data were sensitivity test. It means in Hospital Y based on Minister of Health Decree No. 523 of 2015. Conclusion: Based on the ACER value it could be concluded that meropenem therapy in cases of CKD in Hospital X was more effective if carried out with sensitivity test. Pendahuluan : Prevalensi penyakit ginjal kronik (PGK) cukup tinggi. Penggunaan meropenem pada pasien PGK perlu mendapat perhatian. Meropenem adalah antibiotik generasi ketiga yang harganya mahal dan apabila penggunaannya tidak rasional maka menambah biaya pengobatan. Disamping itu ada bahaya resistensi yang berdampak sulitnya pengobatan. Oleh karena itu dilakukan penelitian “Analisis Efektifvitas Biaya antara Penggunaan Meropenem dengan dan tanpa Hasil Uji Sensitivitas Antibiotik pada Pasien PGK Di Rumah Sakit”. Metode penelitian adalah cross sectional. Tempat penelitian dipilih langsung di dua Rumah Sakit di Kota Manado dan Kota Semarang. Data yang digunakan berasal dari data sekunder yang memenuhi kriteria inklusi dan eksklusi. Data dari rekam medis pasien berupa catatan medis dan biaya pengobatan tahun 2016. Alat pengumpul data berupa formulir isian. Hasil: Kasus gagal ginjal kronis yang memenuhi kriteria sebanyak 29 dari RS X yaitu 11 kasus dilakukan uji sensitivitas dan 18 kasus tidak dilakukan uji sensitivitas. Di RS Y didapatkan 20 kasus yaitu 17 kasus dilakukan uji sensitivitas dan 3 kasus tidak dilakukan uji sensitivitas. Di RS X, nilai Average Cost Effectiveness Ratio (ACER) terapi meropenem dengan uji sensitivitas adalah 94.242.994 dan nilai ACER terapi meropenem tanpa uji sensitivitas adalah 142.793.491. Di RS Y tidak bisa dibandingkan antara terapi meropenem dengan dan tanpa uji sensitivitas karena 85% dilakukan uji sensitivitas. Hal ini berarti penggunaan meropenem di RS Y sesuai Kepmenkes No 523 Tahun 2015. Kesimpulan : Berdasarkan nilai ACER disimpulkan bahwa terapi dengan meropenem pada kasus PGK di RS X lebih efektif jika dilakukan dengan uji sensitivitas.

scholarly journals Cost Effectiveness Analysis Therapy Combination of Candesartan-Amlodipine and Candesartan-Diltiazem on Hypertensive Outpatients

2018 ◽  
Vol 14 (2) ◽  
pp. 188
Author(s):  
Faridah Baroroh ◽  
Andriana Sari
Keyword(s):  
Blood Pressure ◽  
Cost Effectiveness ◽  
Blood Pressure Reduction ◽  
Cost Effectiveness Analysis ◽  
Pressure Reduction ◽  
Research Subjects ◽  
Cost Effectiveness Ratio ◽  
Cost Component ◽  
Effectiveness Analysis ◽  
The Cost

Hypertension medication is taken for a long period and thus requires considerable costs. As antihypertensives vary in efficacy, research is needed to assess the cost effectiveness of medication, particularly between candesartan-amlodipine and candesartan-diltiazem combinations on hypertensive outpatients. This study applied a prospective cohort design with outcome observations for three months at a private hospital in Yogyakarta. The outcome used to gauge the cost effectiveness of medication was the achievement of the targeted blood pressure reduction after treatment. The cost effectiveness analysis was conducted through payer’s perspective, namely that of the social security agency (BPJS), with direct medical cost as the cost component measured. Cost effectiveness was analyzed using an average cost effectiveness ratio (ACER), calculated according to the ratio of cost to the outcome percentage of the blood pressure reduction target attainment, and an incremental cost effectiveness ratio (ICER) based on the ratio between differences in cost and outcome in both medication groups. The research subjects consisted of 33 patients, 24 of whom underwent medication with candesartan-amlodipine combination and 9 with candesartan-diltiazem. As many as 81.82% were female and 72.73% were within the age range of 51-70, while their most frequent complication was diabetes mellitus (48.48%). Results revealed the effectiveness of candesartan-amlodipine medication to be 58.33% with an ACER value of IDR 6,617, whereas that of candesartan-diltiazem was 22.22% with an ACER of IDR 29,733. The ICER value was IDR -7607, indicating that candesartan-amlodipine was categorically more cost-effective than candesartan-diltiazem.

scholarly journals Clinical and economic comparison of utilization of reslizumab, mepolizumab and benralizumab in the treatment of severe eosinophilic asthma

2020 ◽  
Vol 92 (12) ◽  
pp. 172-179
Author(s):  
S. K. Zyryanov ◽  
S. N. Avdeev ◽  
D. A. Ivanov ◽  
M. V. Zhuravleva ◽  
N. P. Kniajeskaia ◽  
...  
Keyword(s):  
Cost Effectiveness ◽  
Severe Asthma ◽  
Body Mass ◽  
Budget Impact ◽  
Cost Effectiveness Analysis ◽  
Cost Effectiveness Ratio ◽  
Eosinophilic Asthma ◽  
Severe Eosinophilic Asthma ◽  
Effectiveness Analysis ◽  
The Cost

During last few years, the approaches to the management of patients with severe asthma have been revised. Monoclonal antibodies (MABs), inhibitors of interleukin-5 (reslizumab, mepolizumab, benralizumab) have been recently introduced for the treatment of severe eosinophilic asthma. The mentioned drugs were approved in Russia and included into the list of Vitally Essential Drugs. Aim.The aim of this study was to compare the clinical and economic consequences of the use of biological agents that antagonize IL-5 in the treatment of severe eosinophilic asthma in adults. Materials and methods.Two methods of clinical and economic research were used: assessment of the cost-effectiveness ratio and analysis of the budget impact. The effectiveness of the drugs was assessed using indirect comparison; special attention was paid to comparability of the patient groups in the studies chosen for such an assessment. Two approaches were used for calculation of the cost of therapy for severe asthma: using DRGs (applicable to most regions of Russia), and without the use of DRGs, which is relevant only for few Russian regions. Results.Basing on the data obtained from a budget impact study without the use of DRG, it was shown that reslizumab was dominating for patients with body mass of up to 70 kg, while for the patients with body mass of 70 to 110 kg, mepolizumab was dominating, while utilization of reslizumab appeared to be somewhat more expensive. In the group of patients with body mass over 110 kg, mepolizumab also was dominating. The calculation of the cost-effectiveness ratio (CER) showed that reslizumab appeared to be dominating over two other MABs, The results of the study using the DRG demonstrated that the cost of an annual course of benralizumab in most cases in Russia would exceed the amount that can be compensated by Territorial Funds for Mandatory Medical Insurance to a healthcare institution for therapy of bronchial asthma in one adult patient with genetically engineered drugs. Therefore, further comparisons were made for reslizumab and mepolizumab only. Analysis of the impact on the budget demonstrated that treatment with reslizumab and mepolizumab would represent a similar burden for the budget. When applying cost-effectiveness analysis, reslizumab was more cost-effective than mepolizumab (regardless of patient body mass). Conclusion.Thus, the results of the clinical and economic study suggested that, basing on the cost-effectiveness analysis, reslizumab appeared to be the dominant IL-5 antagonist (regardless of body mass if DRG approach was used and in patients with body mass up to 110 kg, if such an approach was not used). Basing on budget impact analysis, calculations without use of DRG approach showed superiority of reslizumab over mepolizumab and benralizumab for the patients with body mass up to 70 kg and the DRG-based approach showed equal burden for the budget for reslizumab and mepolizumab for the patients with any body mass.

scholarly journals Cost-Effectiveness of Upper Extremity Dry Needling in Chronic Stroke

Healthcare ◽  
2022 ◽  
Vol 10 (1) ◽  
pp. 160
Author(s):  
Daniel Fernández-Sanchis ◽  
Natalia Brandín-de la Cruz ◽  
Carolina Jiménez-Sánchez ◽  
Marina Gil-Calvo ◽  
Pablo Herrero ◽  
...  
Keyword(s):  
Cost Effectiveness ◽  
Cost Effectiveness Analysis ◽  
Chronic Stroke ◽  
Controlled Clinical Trial ◽  
Dry Needling ◽  
Cost Effectiveness Ratio ◽  
Limit Values ◽  
Effectiveness Analysis ◽  
Life Years ◽  
The Cost

Introduction: Dry needling is a non-pharmacological approach that has proven to be effective in different neurological conditions. Objective: The aim of this study was to evaluate the cost-effectiveness of a single dry needling session in patients with chronic stroke. Methods: A cost-effectiveness analysis was performed based on a randomized controlled clinical trial. The results obtained from the values of the EuroQol-5D questionnaire and the Modified Modified Ashworth Scale were processed in order to obtain the percentage of treatment responders and the quality-adjusted life years (QALYs) for each alternative. The cost analysis was that of the hospital, clinic, or health center, including the equipment and physiotherapist. The cost per respondent and the incremental cost-effectiveness ratio of each alternative were assessed. Results: Twenty-three patients with stroke were selected. The cost of DN treatment was EUR 14.96, and the data analysis showed a favorable cost-effectiveness ratio of both EUR/QALY and EUR/responder for IG, although the sensitivity analysis using limit values did not confirm the dominance (higher effectiveness with less cost) of the dry needling over the sham dry needling. Conclusions: Dry needling is an affordable alternative with good results in the cost-effectiveness analysis—both immediately, and after two weeks of treatment—compared to sham dry needling in persons with chronic stroke.

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