Utilization and cost minimization study of antihypertensive drugs in primary healthcare center
Objective: Hypertension is the biggest cause of death in Indonesia, including in the district of Pandeglang, for the category of non-communicable diseases. Since the implementation of National Health Insurance (NHI) in 2014, prevention strategies are expected to be able to improve the control of the patient's systolic blood pressure in the district of Pandeglang through interventions that are more focused on blood pressure changes and treatment cost. However, it is necessary to conduct a cost-minimization analysis of antihypertension drug use since drug cost is responsible with approximately 40% of the total healthcare costs in Indonesia. In the context of management on the use of antihypertension drugs at primary healthcare centers, this study was aimed to analyze the cost minimization of hypertension treatment in the district of Pandeglang in a period of 2014-2016 by taking into account the drug utilization and its cost consequences. Material and method: Data related to drug utilization was collected retrospectively from the Department of Health. The economic evaluation was conducted by applying Drug Utilization 90% (DU90%) and Cost Minimization Analysis (CMA) methods. Result: The results showed that captopril 25mg was obviously included in both 75% and 90% segments each year. Other drugs with the highest frequency included amlodipine 5mg and 10mg, captopril 12.5mg, furosemide 40mg, HCT, reserpine 0.25mg, and amlodipine besylate 5mg. Cost per Defined Daily Dose (DDD) was estimated to be Rp 58 (18%), Rp 195 (80%), and Rp 68 (25%) per DDD in 2014, 2015, and 2016, respectively, when a threshold of 90% in the drug utilization was applied. When a threshold of 75% was applied, cost/DDD would be Rp 62 (18%), Rp 208 (79%), and Rp 68 (23%) per DDD in 2014, 2015, and 2016, respectively. Conclusion: It can be concluded that the first year of NHI implementation yielded the lowest cost/DDD.
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