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All Journal JURNAL FARMASI DAN ILMU KEFARMASIAN INDONESIA Jurnal Ilmiah Ibnu Sina (JIIS): Ilmu Farmasi dan Kesehatan Denta: Jurnal Kedokteran Gigi
Libriansyah
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Chemistry Dentistry Education Health Professions Medicine & Pharmacology Other

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A Systematic Review: Cost-Effectiveness of SGLT2 Inhibitors versus DPP-4 Inhibitors as Add-on to Metformin Hanifiyah, Izzatu Al; Nita, Yunita; Libriansyah; Ridwan, Achmad
JURNAL FARMASI DAN ILMU KEFARMASIAN INDONESIA Vol. 12 No. 2 (2025): JURNAL FARMASI DAN ILMU KEFARMASIAN INDONESIA
Publisher : Universitas Airlangga

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.20473/jfiki.v12i22025.256-263

Abstract

Background: The prevalence of type 2 diabetes mellitus (T2DM) is increasing worldwide. Sodium-glucose cotransporter-2 inhibitors (SGLT2i) and dipeptidyl peptidase-4 inhibitors (DPP-4i) are two second-line therapy alternatives for T2DM patients inadequately controlled with metformin. Objective: This study aimed to systematically review the cost-effectiveness of combining metformin+SGLT2i vs metformin+DPP-4i for T2DM treatment. Methods: A systematic search was conducted in PubMed, Scopus, and ScienceDirect for articles published between 2015-2025, using predefined keywords and following the PRISMA and PICOS frameworks (P: T2DM patients uncontrolled on metformin monotherapy; I: Metformin+SGLT2i therapy; C: Metformin+DPP-4i therapy; O: Cost, clinical outcomes (HbA1c% reduction), Incremental Cost-Effectiveness Ratio (ICER) values, Quality Adjusted Life Years (QALY); S: Study with cost-effectiveness analysis design). Additional studies were identified through reference screening. Eligible articles were independently reviewed and assessed for reporting quality using the CHEERS-2022 standards. Results: Five studies met the inclusion criteria. Considerable heterogeneity was observed with mean patient ages ranging from 55-61 years old and baseline HbA1c levels from 7.9%-9.4%. The studies were conducted in the US, UK, Mexico, and Greece, all funded by the pharmaceutical industry, and used economic models. Despite these differences, all studies consistently demonstrated that combining metformin+SGLT2i was more cost-effective than metformin+DPP-4i. SGLT2i improved the quality of life by 0.032–0.04 QALYs, reduced hypoglycemia, and provided additional benefits for patients with cardiovascular risk, although it was associated with higher initial costs. Conclusion: This review showed that the combination of metformin+SGLT2i was more cost-efficient and effective in managing T2DM than the combination of metformin+DPP-4i.
Oral Health Care Management in Atypical Oral and Cutaneous Bullous Pemphigoid Widowati, Kharinna; Dewanthy P, Sri; Lukisari, Cane; Nafi’ah; Setianingtyas, Dwi; Rahman, Kurnia Hayati; Libriansyah; Riyanto, Eko; Damaiyanti, Dian W; Ayuningtyas, Nurina F.
Denta Journal Kedokteran Gigi Vol 20 No 1 (2026): Februari
Publisher : Fakultas Kedokteran Gigi Universitas Hang Tuah

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.30649/denta.v20i1.4

Abstract

Background: Bullous Pemphigoid (BP) is the most common subepidermal bullous autoimmune disease, typically presenting as tense bullae. Atypical presentations of bullous pemphigoid often mimic TEN or impetigo, creating diagnostic ambiguity. Effective management of these cases requires integrated strategies to address systemic health factors and extensive oral mucosal involvement. Objective: This report highlights the Oral Health Care Management of atypical oral and cutaneous manifestations of Bullous Pemphigoid. Case: A 58-year-old woman with a history of Diabetes Mellitus and heart disease was referred with extensive bullae, erosions, and "honey-like" crusts involving over 30% of her body surface area. Her condition worsened despite two weeks of treatment with acyclovir, which was administered for suspected herpes. The presentation was highly suggestive of TEN and impetigo. Case Management: Management of the oral and perioral lesions focused on infection prevention and pain relief. Debridement was performed using sterile gauze soaked in normal saline and 0.2% chlorhexidine. This was followed by the application of Aloevera extract gel/spray. Comprehensive systemic therapy, including corticosteroids and immunosuppressants, was coordinated by a multidisciplinary team to control the autoimmune disease and its comorbidities. Conclusion: The presence of comorbidities, such as diabetes, further complicates systemic management and heightens the risk of secondary infections, requiring meticulous wound care. A multidisciplinary diagnostic algorithm, supported by supplementary examinations, is crucial for differentiating atypical BP from TEN and impetigo infection. Adequate management of associated oral and perioral manifestations is an integral component of comprehensive patient care.
ANALISIS BIAYA PADA PASIEN GANGGUAN HORMON TIROID DI RUMAH SAKIT PUSAT ANGKATAN LAUT DR. RAMELAN SURABAYA Nabila, Muthma'innatun; Nita, Yunita; Libriansyah; Lestiono; Ridwan, Achmad
Jurnal Ilmiah Ibnu Sina (JIIS): Ilmu Farmasi dan Kesehatan Vol 11 No 1 (2026): Jurnal Ilmiah Ibnu Sina
Publisher : Sekolah Tinggi Ilmu Kesehatan ISFI Banjarmasin

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.36387/jiis.v11i1.2854

Abstract

Thyroid hormone disorders, such as hyperthyroidism and hypothyroidism, are common endocrine diseases that impose a considerable economic burden. This study aimed to analyze the components of treatment costs among outpatients with thyroid hormone disorders at RSPAL Dr. Ramelan Surabaya and to examine the relationship between patient characteristics and total treatment costs. A cross-sectional design was employed from both patient and hospital perspectives, involving 86 outpatients during the period of May to July 2025. Data on direct medical costs were obtained from the hospital billing system and out-of-pocket expenses through patient interviews, while direct non-medical and indirect costs were collected through structured interviews. The results showed that most patients were female (69 patients; 80.23%) with a mean age of 42 years, and hyperthyroidism was the most common diagnosis (n=54). The total annual cost reached IDR 1,618,002,478, with an average of IDR 18,813,982 per patient. Direct medical costs represented the largest component, with laboratory examinations accounting for the highest expenditure (an average of IDR 8,245,814 per patient per year). Statistical analysis revealed significant associations between age (p=0.007) and BPJS insurance class (p=0.049) with direct medical costs, employment status (p=0.025) with direct non-medical costs, and both age (p=0.014) and employment status (p=0.000) with indirect costs. In conclusion, the treatment costs of thyroid disorders are predominantly driven by direct medical expenses, with variations influenced by age and insurance class.
Co-Authors Achmad Ridwan, Achmad Ayuningtyas, Nurina F. Cane Lukisari, Cane Dewanthy P, Sri Dian W Damaiyanti, Dian W Dwi Setianingtyas Hanifiyah, Izzatu Al Kharinna Widowati, Kharinna Lestiono Nabila, Muthma'innatun Nafi’ah Rahman, Kurnia Hayati Riyanto, Eko Yunita Nita