<![CDATA[Introduction: Pharmaceutical procurement represents a significant proportion of hospital expenditure, with drug inventory accounting for approximately 10-20% of of total hospital costs. The ABC-VEN analysis has been widely used to improve pharmaceutical inventory management, but evidence regarding its application in outpatient cardiology services within Indonesia’s National Health Insurance (JKN) system remains limited. This study aims to evaluate drug use patterns, pharmaceutical expenditure, and inventory priorities using ABC–VEN analysis in outpatient cardiology services under Indonesia’s National Health Insurance (JKN) system. Methods: A retrospective observational study was conducted using all outpatient prescriptions under the national health insurance program in the cardiology clinic from January to March 2020. The ABC method carried out the analysis of drug use patterns and cost. ABC-VEN matrix was formulated by combining the results of ABC and VEN analysis. Results: A total of 4.443 prescriptions contained 482.457 items from 125 types of drugs. Based on usage value, Classes A, B, and C accounted for 68%, 21%, and 11%, respectively, while based on invesment value, they accounted for 68%, 27%, and 5%. Class A drug usage and cost represent only 6% and 2% of total drug types. VEN analysis identified no Vital drugs, whereas Essential medicines accounted for 94% of total drug utilization and 98% of total pharmaceutical expenditure The ABC-VEN matrix showed drug usage in Categories I, II, and III at 34%, 60%, and 6%, with the corresponding drug costs for 68%, 30%, and 2%. Category I drugs represented 34% of total drug use but consumed 68% of total pharmaceutical expenditure, indicating substantial budget concentration in a limited number of essential high-cost medicines. Conclusion: The ABC analysis based on usage value and invesment value and VEN analysis shows differing patterns. Pharmaceutical expenditure in outpatient cardiology services was highly concentrated among a limited number of essential medicines. ABC–VEN analysis provides a practical framework for procurement prioritization, budget optimization, and strategic inventory control, thereby supporting more efficient pharmaceutical management and sustainable medication availability.]]>
