ANALISIS EFEKTIVITAS BIAYA PENGGUNAAN INSULIN DIBANDINGKAN KOMBINASI INSULIN-METFORMIN PADA PASIEN DIABETES MELITUS TIPE 2 - Primadiamanti, Annisa; Andayani, Tri Murti (Indonesian Research Gateway)
The use of metformin in insulin therapy hopefully could increase effectiveness of type 2 diabetes treatment equal with the expenditure. Non experimental research was conducted to investigate cost-effectiveness of insulin use and insulin-metormin combination. Data was taken prospectively from baseline until month 3. The measurable cost was direct medical cost which covered cost of antidiabetic drugs, cost of complication drugs, doctor’s fee, and cost of laboratory checkup. The measurable effectiveness of therapy was reduction of FPG and HbA1c level. ACER (average cost-effectiveness ratio) was calculated based on cost and effectiveness ratio in both groups. ICER (incremental cost-effectiveness ratio) was calculated based on difference of cost and effectiveness ratio in both groups. Results showed FPG level reduction in insulin group and insulin-metformin combination consecutively was 25,05% and 1,03%. Increase of HbA1c level in insulin group and insulin-metformin combination consecutively was 6,21% and 1,87%. Based on HbA1c level reduction, ACER value in insulin group and insulin-metformin combination consecutively was Rp -37.617,00 and Rp -161.729,00, ICER value was Rp 15.860,00. From the results it can be concluded that insulin-metformin combination was more cost-effective than insulin in maintaining HbA1c level. ABSTRAK Penelitian ini dirancang untuk mengetahui efektivitas biaya pada pasien DM tipe 2 yang menggunakan insulin dan kombinasi insulin-metformin. Data diambil secara prospektif dari baseline hingga bulan ke-3. Analisis efektivitas biaya dilakukan dengan perspektif ASKES. Komponen biaya yang diukur adalah biaya medik langsung, mencakup biaya antidiabetik, biaya komplikasi, biaya kunjungan ke klinik dan biaya pemeriksaan laboratorium. Efektivitas terapi yang diukur adalah penurunan kadar GDP dan HbA1c. ACER (average cost-effectiveness ratio) dihitung berdasarkan rasio biaya dan efektivitas terapi pada kedua kelompok terapi. ICER (incremental cost-effectiveness ratio) dihitung berdasarkan rasio antara selisih biaya dan efektivitas terapi pada kedua kelompok terapi. Hasil penelitian menunjukkan penurunan kadar GDP pada kelompok insulin dan kombinasi insulin-metformin berurutan adalah 25,05% dan 1,03%. Peningkatan kadar HbA1c pada kelompok insulin dan kombinasi insulin-metformin berurutan adalah 6,21% dan 1,87%. Berdasarkan penurunan kadar HbA1c, nilai ACER pada kelompok insulin dan kombinasi insulin-metformin berurutan adalah Rp -37.617,00 dan Rp -161.729,00, nilai ICER adalah Rp15.860,00. Berdasarkan hasil penelitian dapat disimpulkan bahwa kombinasi insulin-metformin lebih cost-effective dalam mempertahankan kadar HbA1c.