The Indonesian Biomedical Journal
Vol 5, No 1 (2013)

Cost-Effectiveness Analysis of Pharmacotherapy for Hematemesis-Melena Treatment in Hospitalized Patients with Hepatic Cirrhosis

Doddy de Queljoe (Pharmacy Faculty, Surabaya University Jl. Ngagel Jaya Selatan 169, Surabaya)
Amelia Lorensia (Pharmacy Faculty, Surabaya University Jl. Ngagel Jaya Selatan 169, Surabaya)
Liana Widharta (Pharmacy Faculty, Surabaya University Jl. Ngagel Jaya Selatan 169, Surabaya)
Sugiarto Widjaja (Adi Husada Undaan Wetan Hospital Jl. Undaan Wetan No.40-44, Surabaya, Jawa Timur)



Article Info

Publish Date
01 Apr 2013

Abstract

BACKGROUND: Acute variceal haemorrhage is a complication of cirrhosis that can be life threatening. It is a pharmacist’s duty to ensure therapeutic and pharmaceutical care which is not only safe and effective for the patient but also is cost-effective in order to attain improvement of the patient’s quality of life. Therefore, pharmacoeconomic evaluation especially cost-effectiveness analysis (CEA), which compares costs and consequences of drug therapy, is needed. This study was aimed to evaluate the therapeutic cost-effectiveness of hematemesis-melena treatment in hepatic cirrhotic patients.METHODS: A total of 42 patients receiving vitamin K and vitamin K-transamin were studied retrospectively from patients’ medical records in 2 years and analyzed with cost-effectiveness grid and average cost-effectiveness ratio (ACER) based on Child-Turcotte-Pugh (CTP) Score.RESULTS: Cost-effectiveness grid was dominant for vitamin K in patients with CTP Score A. ACER analysis showed a lower score for vitamin K in all patients included CTP Score classification. There was no significant difference in duration of cessation of bleeding treatment in patients with vitamin K compared with vitamin K-transamin in patients with CTP Score A and B, while significant difference was found in patients with CTP Score C.CONCLUSION: Vitamin K appeared to be more cost effective as compared with vitamin K-transamin in all patients. The use of vitamin K had greater benefit than the combination with transamin in all patients and CTP Score classification, and thus should be considered as a primary therapy. Therefore, transamin addition as an alternative therapy for hepatic cirrhosis patients with hematemesis-melena should be considered.KEYWORDS: CEA, cost-effectiveness analysis, child-turcotte-pugh score, hepatic cirrhosis, hematemesismelena, vitamin K, transamin

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