Cost-Effectiveness Analysis of Antihypertensive Drugs in Hypertensive Patients with Diabetes Mellitus Comorbidity in Inpatient Patients of Bengkulu Province, Indonesia
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Abstract
In 2023, hypertensive inpatients with diabetes mellitus (DM) comorbidity were predominantly treated at Kaur Regional Hospital (KRH) and Harapan dan Doa Hospital (HDH) in Bengkulu Province, Indonesia. This study aimed to analyze the cost-effectiveness of inpatients of hypertension-DM therapy management strategies for social security administrators at KRH and HDH during 2022-2023. A cost-effectiveness analysis was conducted using retrospective medical records from January 2022 to December 2023. The drugs compared were amlodipine-captopril and bisoprolol-amlodipine. Additionally, KRH used candesartan-furosemide and HDH used amlodipine-candesartan as alternative treatments. The outcome parameter measured was a decrease in blood pressure. The analysis adopted the hospital perspective, focusing on direct cost components. The study included 112 and 118 patients from KRH and HDH, respectively, aged between 25 and 59. The incremental cost-effectiveness ratio (ICER) at KRH in 2022 was IDR 5,159/mmHg for systolic blood pressure reduction and IDR 4,711/mmHg for diastolic blood pressure reduction (comparing candesartan-furosemide with amlodipine-captopril). In 2023, the ICER was IDR 862,922/mmHg for systolic reduction and IDR 251,685/mmHg for diastolic reduction (comparing amlodipine-captopril with bisoprolol-amlodipine). At HDH in 2022, the ICER for systolic reduction was IDR 96,643/mmHg, and for diastolic reduction, it was IDR 2,967/mmHg (comparing amlodipine-captopril with bisoprolol-amlodipine). In 2023, the ICER was IDR 339,000/mmHg for systolic reduction (comparing amlodipine-candesartan with amlodipine-captopril) and IDR 37,474/mmHg for diastolic reduction (comparing amlodipine-captopril with bisoprolol-amlodipine). In conclusion, amlodipine-captopril was more cost-effective than bisoprolol-amlodipine at KRH in 2022 and HDH in 2023. However, switching to amlodipine-captopril required additional costs at KRH in 2023 and HDH in 2022.
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