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All Journal JSFK (Jurnal Sains Farmasi & Klinis)
Najmiatul Fitria
Faculty of Pharmacy, Andalas University
Biochemistry, Genetics & Molecular Biology Health Professions Immunology & microbiology Medicine & Pharmacology Public Health

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Comparative Economic and Clinical Utility of Adding Candesartan for Hypertension Management Najmiatul Fitria; Thang Nguyen; Afifah Machlaurin; Nabila Al Rizka; Dian Ayu Juwita
JSFK (Jurnal Sains Farmasi & Klinis) Vol 11 No 2 (2024): J Sains Farm Klin 11(2), August 2024
Publisher : Fakultas Farmasi Universitas Andalas

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.25077/jsfk.11.2.111-117.2024

Abstract

Introduction: Antihypertensive drugs require high costs because they are used over a long period. Therefore, consideration is needed in drug selection requirements, effectiveness, and price. This study aimed to see the beneficial results of hypertension therapy and the non-medical costs incurred by patients using cost-utility analysis (CUA). Method: This research was a prospective study. The incremental Cost-Utility Ratio (ICUR) of antihypertensive treatment was calculated using cost-utility data obtained through EQ-5D-5L questionnaires from outpatients at Universitas Andalas Hospital in January- March 2023 who met the inclusion and exclusion criteria. The costs used were from a patient perspective, consisting of direct medical and non-medical costs. This study compared standard treatment (amlodipine) with the addition of candesartan. Results: The number of respondents in this study was 67, consisting of 23 respondents (34.33%) using amlodipine alone and 44 respondents (65.67%) using the amlodipine-candesartan combination. The ICUR value obtained was IDR7,318,674/QALY. The difference in the average utility value of the amlodipine-candesartan combination with amlodipine alone is -0.02, and the difference in cost is -IDR12,224. Based on the cost-utility diagram, the amlodipine-candesartan combination group is included in the southwest quadrant (quadrant III), which illustrates that the cost required for the amlodipine-candesartan combination group is lower than the cost of the amlodipine single treatment group and the outcome is also not better (slightly lower or the same). Conclusion: It was recommended to prioritize using amlodipine alone for hypertension management, as it provides similar outcomes to the amlodipine-candesartan combination while incurring lower costs.
Cost-Effectiveness of ACTH vs. ACT Chemotherapy Regimens at RSUP Dr. M. Djamil Nadiatul Aulia Zahara Rizki; Dita Permatasari; Fitri Handayani; Ridho Asra; Najmiatul Fitria
JSFK (Jurnal Sains Farmasi & Klinis) Vol 12 No 2 (2025): J Sains Farm Klin 12(2), August 2025
Publisher : Fakultas Farmasi Universitas Andalas

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.25077/jsfk.12.2.138-144.2025

Abstract

Introduction: Breast cancer is one of the most common cancers and is often diagnosed at a late stage, especially in Indonesia. This highlights the need for cost-effective treatment options. ACT (Adriamycin, Cyclophosphamide, and Taxane) and ACTH (ACT plus Herceptin/Trastuzumab) are used chemotherapy regimens, but studies comparing their cost-effectiveness are still limited. This study aimed to evaluate the cost-effectiveness of ACT versus ACTH for breast cancer treatment using tumor volume reduction. Method: A retrospective cost-effectiveness study was carried out at Dr. M. Djamil Hospital by comparing direct medical costs and tumor volume changes in breast cancer patients treated with ACT or ACTH regimens. Effectiveness was based on the average change in tumor volume, and cost-effectiveness was evaluated using the Incremental Cost-Effectiveness Ratio (ICER). Results: The mean tumor volume reduction in the ACT group was 2820.85 ± 11190.42 cm³, and significantly higher at 9273.50 ± 60101.33 cm³ in ACTH, although the difference was not statistically significant (p = 0.614). The average direct medical cost for ACTH was IDR 67,138,579, compared to IDR 13,005,027 for ACT. The ICER calculation resulted in IDR-838,935 per cm³ of tumor reduction, while the negative ICER might suggest cost savings, it does not imply that ACTH is a dominant strategy indicating that ACTH incurred a higher cost with less effectiveness per unit of tumor reduction than ACT. Conclusion: The high associated cost leads to a negative ICER, suggesting that ACT may be more cost-effective in this setting. These findings are critical for optimizing chemotherapy choices within limited healthcare budgets.
Co-Authors Afifah Machlaurin Dian Ayu Juwita Dita Permatasari Fitri Handayani Nabila Al Rizka Nadiatul Aulia Zahara Rizki Ridho Asra Thang Nguyen