Cost-effectiveness analysis of metformin and metformin-glimepiride in patients with type 2 diabetes at nene mallomo sidrap general hospital
DOI:
https://doi.org/10.12928/mf.v19i2.21608Keywords:
Cost-Effectiveness Analysis, Diabetes Mellitus, Glimepiride, MetforminAbstract
Metformin and metformin-glimepiride are cost-effective therapy options and are most commonly prescribed to treat type 2 diabetes mellitus (DM). This study aims to determine the cost-effectiveness of using metformin and metformin-glimepiride in patients with type 2 DM at Nene Mallomo Sidenreng Rappang General Hospital. This analytical descriptive observational research employed a retrospective cohort design. The data of type 2 DM patients, new and old patients, were obtained from the medical record unit. The target population was data of outpatients for the period January-December 2019. The parameter of the therapeutic effectiveness is the random blood sugar levels of the patients after receiving treatment. The data on cost from the hospital perspective were obtained from the administration and finance unit. Cost-effectiveness analysis employed calculations of the average cost-effectiveness ratio (ACER) and the incremental cost-effectiveness ratio (ICER). Meanwhile, the risk ratio (RR) employed the analytical chi-squared method to determine the relationship between the two types of therapies and their effectiveness. This study has revealed that 30 patients met the inclusion criteria; 14 patients received metformin therapy and 16 patients received metformin-glimepiride therapy. Metformin therapy is more effective (64.29%) and more costly (IDR120,736). The metformin's ACER value is 1877.99, and its ICER value is -3107.26. The cost-effectiveness analysis has revealed that metformin therapy is more cost-effective than metformin-glimepiride therapy. Meanwhile, the chi-squared analysis has discovered no relationship between the two therapies and their effectiveness. The RR value of 1.080 concludes that metformin has 1.080 as much therapeutic effectiveness as the metformin-glimepiride.
References
Andayani, T. M. (2013) Farmakoekonomi Prinsip Dan Metodologi. Cetakan I. Yogyakarta: Bursa Ilmu.
Bang, H. and Zhao, H. (2012) ‘Median-based incremental cost-effectiveness ratio (ICER)’, Journal of Statistical Theory and Practice, 6(3), pp. 428–442. doi: 10.1080/15598608.2012.695571.
Cho, N. H. et al. (2018) ‘IDF Diabetes Atlas : Global estimates of diabetes prevalence for 2017 and projections for 2045’, Diabetes Research and Clinical Practice, 138, pp. 271–281. doi: 10.1016/j.diabres.2018.02.023.
Diani, A. and Pulungan, A. B. (2010) ‘Tata laksana Metformin Diabetes Mellitus Tipe 2 pada Anak Dibandingkan dengan obat Anti Diabetes Oral yang lain’, Sari Pediatri, 11(6), pp. 395–400.
Dinaryanti, P., Fundholi, A. and Andayani, T. M. (2012) ‘Analisis Biaya dan Efektivitas Terapi Pasien Diabetes Melitus Tipe 2’, Jurnal Manajemen dan Pelayanan Farmasi, 2(1), pp. 14–19.
Dipiro, J. T. et al. (2015) ‘Pharmacotherapy Handbook Ninth Edition’, in Mc Graw Hill Education, New York.
Dipiro J et al. (2015) Pharmacoterapy A Phatophysiologic Approach, AIAA Guidance, Navigation, and Control Conference.
Evi, K. and Yanita, B. (2016) ‘Faktor-Faktor yang Berhubungan dengan Kejadian Diabetes Melitus Tipe II’, Majority, 5(2), pp. 27–31. Available at: http://juke.kedokteran.unila.ac.id/index.php/majority/article/view/1073.
Fatimah, R. N. (2015) ‘Diabetes Melitus Tipe 2’, J Majority, 4(5), pp. 93–101.
Ferrannini, E. (2014) ‘The Target of Metformin in Type 2 Diabetes’, New England Journal of Medicine (NEJM), 371(16), pp. 1547–1548. doi: 10.1056/NEJMcibr1409796.
Hauri, L. Z. and Faridah, I. N. (2019) Kajian Efektivitas Penggunaan Obat pada Pasien Diabetes Melitus Tipe 2 di 3 Pusesmas Kota Yogyakarta. Universitas Ahmad Dahlan Yogyakarta.
Ilahi, O. R. (2014) ‘Analysis of Metformin Combination Therapy with Addition of one Antidiabetic Drugs Selection in Type 2 Diabetes Mellitus Patients Cross Sectional Study Oktavian Rizki Ilahi Abstract Analisa Pemilihan Terapi Kombinasi Metformin dengan Penambahan Satu Obat A’, Universitas Gajah Mada.
Kemenkes.RI (2019) Laporan Provinsi Sulawesi Selatan Riskesdas 2018, Badan Penelitian Dan Pengembangan Kesehatan.
Kemenkes (2013) ‘Pedoman Penerapan Kajian Farmakoekonomi’, pp. 1–72.
Kemenkes (2014) Info DATIN, Pusat Data dan Informasi Kementrian Kesehatan RI, Kementrian Kesehatan RI. Jakarta.
Kemenkes (2018) Hasil Utama Riskesdas 2018. Jakarta.
Kemenkes (2019) ‘Pedoman Pelayanan Kefarmasian Pada Diabetes Melitus’, pp. 1–85.
Khoiriyah, S. D. and Lestari, K. (2018) ‘Review Artikel: Kajian Farmakoekonomi Yang Mendasari Pemilihan Pengobatan Di Indonesia’, Farmaka, 16(3), pp. 134–145.
Laelasari, E., Sauriasari, R. and Banun, A. (2017) ‘Cost-effectiveness analysis of insulin, sulfonylurea, and sulfonylurea– Metformin in type 2 diabetes mellitus’, Asian Journal of Pharmaceutical and Clinical Research, 10(5), pp. 50–53. doi: 10.22159/ajpcr.2017.v10s5.23094.
Marewa, L. W. (2015) Kencing Manis (Diabetes Mellitus) di Sulawesi Selatan.
Pitaloka, S. L. D. and Wibisono, B. H. (2015) ‘Beberapa Faktor Risiko yang Berhubungan dengan Kematian Pasien Pneumonia Komunitas di RSUP DR. Kariadi Semarang’, Media Medika Muda, 4(4), pp. 1495–1502.
Polat, M. et al. (2017) ‘Pneumonia in Patients with Diabetes Mellitus : A Single-Center Experience’, Eurasian Journal of Medicine and Oncology, 1(1), pp. 14–18. doi: 10.14744/ejmo.2017.30974.
Priharsi, A., Mutmainah, N. and Suharsono (2015) ‘Analisis Efektivitas Biaya Antidiabetik Oral pada Penderita Diabetes Melitus Tipe 2 Rawat Jalan Peserta BPJS di Rumah Sakit Umum Daerah DR. Moewardi Tahun 2014’, Universitas Muhammadiyah Surakarta, pp. 1–13.
Puspasari, R. and Hidayati, H. B. (2020) ‘Peran Diabetes Melitus pada Gejala Klinis Osteoartritis Lutut’, Cermin Dunia Kedokteran-285, pp. 287–290.
Rascati, K. L. (2009) ‘Essentials of pharmacoeconomics’, Journal of Commercial Biotechnology, 15(1), pp. 92–94. doi: 10.1057/jcb.2008.45.
Refasi, N. L., Lolo, W. A. and Bodhi, W. (2018) ‘Analisis Efektifitas Biaya (Cost Effectiveness Analysis) Pada Pengobatan Pasien Malaria Falciparum Di RSUD Nabire’, PHARMACON Jurnal Ilmiah Farmasi – UNSRAT, 7(2), pp. 1–9.
Rosano, G. M., Vitale, C. and Seferovic, P. (2017) ‘Heart Failure in Patients with Diabetes Mellitus’, Cardiac Failur Review, 3(1), pp. 52–55. doi: 10.15420/cfr.2016.
Soelistijo, S. A. et al. (2019) ‘Pedoman Pengelolaan dan Pencegahan Diabetes Melitus Tipe 2 Dewasa di Indonesia 2019’, in Perkeni, pp. 1–118.
Ugoni, A. and Walker, B. F. (1995) ‘The chi-square test: An Introduction’, Comsig Review, 4(3), pp. 61–64. doi: 10.1016/j.ajodo.2016.08.009.
Wilkinson, M. J., Zadourian, A. and Taub, P. R. (2019) ‘Heart Failure and Diabetes Mellitus : Defining the Problem and Exploring the Interrelationship’, The American Journal of Medicine, 132(10S), pp. S3–S12. doi: 10.1016/j.amjmed.2019.08.004.
Williams, M. F. et al. (2016) ‘Type 2 diabetes and osteoarthritis : a systematic review and meta-analysis’, Journal of Diabetes and Its Complications, xxx(xxx), pp. 1–7. doi: 10.1016/j.jdiacomp.2016.02.016.
Wulandari, O. and Martini, S. (2013) ‘Perbedaan Kejadian Komplikasi Penderita Diabetes Melitus Tipe 2 Menurut Gula Darah Acak’, Jurnal Berkala Epidemiologi, 1(2), pp. 182–191.
Zamri, A., Oktaliani, R. and Herlambang (2020) A Case: Optimal Treatment of Hyperosmolar Hyperglycemic State (HHS).
Downloads
Published
Issue
Section
License
Authors who publish with Media Farmasi agree to the following terms:
- Authors retain copyright and grant the journal the right of first publication with the work simultaneously licensed under a Creative Commons Attribution License (CC BY-SA 4.0) that allows others to share the work with an acknowledgement of the work's authorship and initial publication in this journal.
- Authors are able to enter into separate, additional contractual arrangements for the non-exclusive distribution of the journal's published version of the work (e.g., post it to an institutional repository or publish it in a book), with an acknowledgement of its initial publication in this journal.
- Authors are permitted and encouraged to post their work online (e.g., in institutional repositories or on their website) prior to and during the submission process, as it can lead to productive exchanges, as well as earlier and greater citation of published work.
This work is licensed under a Creative Commons Attribution 4.0 International License