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All Journal Bionatura Majalah Kedokteran Bandung Jurnal Kesehatan Masyarakat Althea Medical Journal Global Medical and Health Communication Sari Pediatri Jurnal Sistem Kesehatan Padjadjaran Journal of Dentistry Paediatrica Indonesiana Midwifery Journal: Jurnal Kebidanan UM. Mataram Indonesian Journal of Obstetrics and Gynecology (Majalah Obstetri dan Ginekologi Indonesia) Jurnal Pendidikan dan Pelayanan Kebidanan Indonesia (Indonesian Journal of Education and Midwifery Care) Indonesian Journal for Health Sciences (IJHS) JTP - Jurnal Teknologi Pendidikan Care : Jurnal Ilmiah Ilmu Kesehatan Jurnal Kesehatan 2-TRIK: TUNAS-TUNAS RISET KESEHATAN Review of Primary Care Practice and Education (Kajian Praktik dan Pendidikan Layanan Primer) Journal of the Indonesian Medical Association : Majalah Kedokteran Indonesia Indonesian Journal of Global Health research JK Unila (Jurnal Kedokteran Universitas Lampung) Indian Journal of Forensic Medicine & Toxicology Jurnal Ilmu Keperawatan dan Kebidanan International Journal of Health Sciences Journal Integration of Management Studies Journal of Global Research in Public Health Kesmas: Jurnal Kesehatan Masyarakat Nasional (National Public Health Journal)
Dany Hilmanto
Department Of Child Health, Universitas Padjadjaran Medical School/Dr. Hasan Sadikin General Hospital, Bandung, West Java
Agriculture, Biological Sciences & Forestry Biochemistry, Genetics & Molecular Biology Decision Sciences, Operations Research & Management Dentistry Education Environmental Science Health Professions Immunology & microbiology Languange, Linguistic, Communication & Media Medicine & Pharmacology Neuroscience Nursing Public Health Other

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Journal : Journal Integration of Management Studies

 1 
Comparison Of Steroid-Resistant Nephrotic Syndrome Therapy In Children Using Alkylating Agents, Calcineurin Inhibitors, And Monoclonal Antibodies: A Cost-effective Perspective Widiasta, Ahmedz; Rahadi, Raden Aswin; Bagaskara, Danang Pangestu Gusti; Rachmadi, Dedi; Hilmanto, Dany
Journal Integration of Management Studies Vol. 3 No. 1 (2025)
Publisher : Integrasi Sains Media

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.58229/jims.v3i1.293

Abstract

Chronic kidney disease (CKD) poses significant medical and economic challenges, particularly in pediatric patients, with steroid-resistant nephrotic syndrome (SRNS) being a major contributor. Despite the financial support provided by Indonesia’s BPJS health insurance system, the rising prevalence of SRNS necessitates a reassessment of treatment strategies. This study retrospectively analyzed pediatric SRNS cases at Hasan Sadikin General Hospital, Bandung, from 2010 to 2019, focusing on the effectiveness and cost-efficiency of different treatment regimens, including calcineurin inhibitors (CNIs) and cyclophosphamide (CPA). Among 2,590 SRNS cases, CPA achieved a remission rate of 48.75%, whereas CNIs demonstrated superior efficacy, with tacrolimus (96.87%) and cyclosporine A (75.61%) achieving significantly higher remission rates in 2018–2019. Although CNIs incurred higher initial costs, they were more cost-effective in the long term. Rituximab (RTX) emerged as a promising alternative, with a 90% remission rate, offering potential savings by reducing disease progression and preventing more expensive treatments associated with advanced CKD. These findings highlight the necessity for a strategic shift in SRNS treatment protocols, emphasizing not only immediate costs but also long-term health outcomes and financial sustainability. Integrating RTX into standard treatment guidelines could enhance patient prognosis while optimizing healthcare expenditures. However, further research is needed to evaluate the long-term health impacts, expand the demographic scope, and refine cost-effectiveness analyses. A comprehensive approach to SRNS management, prioritizing both clinical efficacy and economic viability, is crucial to improving pediatric CKD outcomes and ensuring the sustainability of national healthcare resources.
Co-Authors Achadiyani Adi Utomo Suardi Ahmedz Widiasta Allania Hanung Putri Sekar Ningrum Andar Laura Nainggolan Ani Kusumastuti Ani Melani Maskoen Anita Deborah Anwar Aprianti, Nurul Azmi Aris Primadi Ariyati Mandiri Arva Rochmawati Astuti Dyah Bestari Bagaskara, Danang Pangestu Gusti Balkis Fitriani Faozi Benny Muliawan Betty Agustina Boed Sinai Singadipoera Bony Lestari Budi Handono Cissy Kartasasmita dadang Hudaya Somasetia Dadang Hudaya Somasetia Dedi Rachmadi Dedi Rachmadi Dedi Rachmadi Deni Sunjaya Dewi Marhaeni Diah Herawati Dewi, Ni Wayan Eka Rahayu Dian Marta Sari Diana Rosifah Dida A Gurnida Dida A. Gurnida Dida Gurnida Dwi Agustian Dwi Agustian Dwi Prasetyo Dzulfikar Djalil Lukmanul Hakim Eddy Fadlyana Eka Ratnasari Eky Setiawan Soeria Soemantri Elsa Pudji Setiawati Elsa Pudji Setiawati Elsa Pudji Setiawati Endah Purnawati Endang Sutedja Endang Sutedja Esti Hitatami Esti Istiqomah Fardila Elba Fardila Elba Farid Husin Farid Husin Farid Husin Firman Fuad Wirakusumah Fitria Fitria Fitria Prabandari Fitriah, Iin Prima Gaga Irawan Nugraha Gizella Gizella Gizella, Gizella Gusti Ayu Pramita aswitami Gustomo Panantro Guswan Wiwaha Hadyana Sukandar Hadyana Sukandar Hardisiswo Soedjana Hasan Purwana Hassan, Hafizah Che Henni Djuhaeni Henny Marina Henny Marina - Herman Susanto Herman Susanto I Made Jawi Ike MP Siregar Imelda M.G Sianipar Indah Yulika Indra Sandinirwan Indria Astuti Intan Karlina Irvan Afriandi Ishak Abdulhak James Thimoty Johanes C Mose Johanes C. Mose Julistio Tb Djais Julistio TB Djais - Kurniaty Ulfah Kurniawati Kurniawati Lestari, Lara Santi Indah Lisa Hasibuan Lisbeth Maria Laurentia Lisbeth Maria Laurentia, Lisbeth Maria Luh Nik Armini Marietta Shanti Mastiur Julianti Merry Wijaya Moudy Emma Unaria Djami Muhammad Ifan Romli Muhammad Ilham Muttaqin Muhammad Nurhalim Shahib Muttaqin, Muhammad Ilham Nanan Sekarwana Nasroen, Saskia Lenggogeni Neneng Syarifah Syafei Neneng Syarifah Syafei, Neneng Syarifah Nintinjri Husnida Nita Arisanti Nita Arisanti Nita Arisanti Noormartany Noormartany Noormartany Nopi Anggista Putri Nur hasanah Nurhalim Shahib Nurhasanah Nurhasanah Nurihsan, Achmad Juntika Oki Suwarsa Panantro, Gustomo Ponpon Ijradinata Ponpon S Idjradinata Prima Nanda Fauziah Putra Haqiqie Adnantama Lubis Qorinah Estiningtyas Sakilah Adnani Raden Tina Dewi Judistiani Rahadi, Raden Aswin Rahmah, Hasni Ridha Mustika Zaif Ridha Mustika Zaif, Ridha Mustika Rosalinna Rosalinna Sari Puspa Dewi Setiawan Setiawan Setyorini Irianti Sri Endah Rahayuningsih Sri Endah Rahayuningsih Sri Sudarwati Susi Susanah Susiarno, Hadi Sutriningsih Syahradian Hasbrima Tetty Yuniati Tetty Yuniati Tetty Yuniati Tina Judistiani Tita Husnitawati Madjid8 Tita Madjid Tri Hanggono Achmad Ulfi Ainun Hanifah Ulfi Ainun Hanifah, Ulfi Ainun Umar, Nur Syazana Veranita Pandia Vita Murniati Tarawan Vita Murniati Tarawan Wahidah Sukriani Welli Hamik Wenny Friska Wiryawan Permadi Yani Dewi Suryani Yoni Syukriani Yundari, Yundari Yuni Susanti Pratiwi Yuni Susanti Pratiwi, Yuni Susanti Zulvayanti Zulvayanti