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Sri Teguh Rahayu, Sri Teguh
Universitas Esa Unggul
Agriculture, Biological Sciences & Forestry Humanities Biochemistry, Genetics & Molecular Biology Chemistry Computer Science & IT Economics, Econometrics & Finance Education Engineering Environmental Science Health Professions Immunology & microbiology Languange, Linguistic, Communication & Media Law, Crime, Criminology & Criminal Justice Mathematics Medicine & Pharmacology Nursing Physics Public Health Social Sciences Other

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Journal : JURNAL FARMASIMED (JFM)

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Cost-Effectiveness Analysis of Two or Three Dosage Forms of N-Acetylcysteine in ICU Patients with Pneumonia July; Rahayu, Sri Teguh; Khairani, Aura Febri
Jurnal FARMASIMED (JFM) Vol 8 No 1 (2025): Jurnal Farmasimed (JFM)
Publisher : Fakultas Farmasi Institut Kesehatan Medistra Lubuk Pakam

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.35451/s13m6d29

Abstract

Background: Pneumonia is an acute infection of the lung tissue caused by various microorganisms, exposure to chemicals, or physical lung damage. The mucolytic N-acetylcysteine (NAC), administered in varying numbers of dosage forms, is frequently used as an adjunctive therapy in the management of pneumonia. Objective: This study evaluated the cost-effectiveness of N-acetylcysteine (NAC) mucolytic therapy using two versus three NAC dosage forms in ICU patients with comorbid pneumonia, by analyzing clinical improvement, ICU length of stay, and drug costs. Methodology: A retrospective observational study was conducted at the Prof. Dr. dr. Mahar Mardjono National Brain Center Hospital, involving medical record data from 88 pneumonia patients, who received two or three NAC dosage forms. Result: Of the patients, 51.1% had a length of stay (LOS) exceeding 9 days, with a higher proportion in the three-dosage-form group (73.7% vs. 45.0%, P = 0.083). Medical records and radiological findings indicated greater clinical improvement in the three-dosage-form group (31.6% vs. 16.0%, P = 0.001). The Average Cost-Effectiveness Ratio (ACER) was Rp20,932 for two dosage forms and Rp27,961 for three dosage forms per 1% effectiveness, demonstrating a lower cost per unit of effectiveness for two dosage forms. The Incremental Cost-Effectiveness Ratio (ICER) was Rp35,169 per 1% additional effectiveness, with an additional cost of Rp548,637 for a 15.6% effectiveness increase in the three-dosage-form group. Conclusion: Therapy with three dosage forms of N-acetylcysteine yields better clinical improvement compared to two dosage forms, but is associated with a longer ICU length of stay and higher drug costs.
Co-Authors Abdurrasyid Abna, Inherni Marti Agung Setiawan Ahmad Mahfud Angelina Pasaribu Ani Vivi Listiyowati Aprilita Rina Yanti Aprilita Rinayanti Asmar, Sarah Aulia Aulia, Sidrah Ayu Ayu Pertiwi, Reza Ayu Puspita Lena Azzahra, Winda Budi Mulyana Chusnul KN, Fakhita Hadlina De Vita Enjelin Dea Fauziyah Eden, Yonatan Elsa Deni Pebrianti Erry Yudha Mulyani Ester Yani Verawati, Ester Yani Evi Medina Oktavia Faiz, Fajrin Nur Ghozaly, Muchammad Reza Harizal Harizal Hendrata, Stephanie Angelica Hurit, Hermanus Ehe Intan Silviana Mustikawati Itsna Taufiqur Rohmah Ivana Thresia Yenhart Julia Julia July July, July Khairani, Aura Febri Khoirunnisa, Shofiyah Lestari, Febry Dwi Luqyyana Hanifah Maulina Rizkyana Megawati Mellova Amir Meutia Faradilla, Meutia Miftahul Ilmy Setiawan Miza Mustika Muchrip Triana, Muchrip Muh Dewa Putra Muhammad Raihan Muhammat Khairun Nafa Mury Kuswari Mustikawati, Intan Silviana Nesya Rizadilla Netanya, Christhabel Vanessa Aurel Nur Septiyani Nur, Syurya Muhammad Nursapitri, Nadya Pratiwi, Anisa Aulia Putu Gita Maya Widyaswari Mahayasih Rachmanida Nuzrina Rachmansyah, Muhamad Reza Rafi Perdana Tamher Rahayu, Windy Rahmatina, Zhafirah Resta Dwi Syachfitri, Resta Dwi Rian Adi Pamungkas Robby Rijal Sauri Rolobessy, Amalia Rosya, Ernalinda Safira Sholihat Safitri, Delia Devi Sari, Rohaniva Yusnia Silviana Dewi Solachudin, Fayza Maghfira Thasha, Yenni Tria Saras Pertiwi Tyas Putri Utami Valent, Lintang Eka Vidianti, Okta Wafiq Qutrotul Aeni Soba Wahyuni, Yulia Yasmine, Azahra Humaira Yosi Valencia Yuliati Yuliati Zahra, Hanifah