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Journal of Health Economic and Policy Research (JHEPR)
Published by Universitas Muhammadiyah Purwokerto
ISSN : -     EISSN : 30255198     DOI : https://doi.org/10.30595/jhepr.v1i1
Core Subject : Economy, Health, Science,
Decision Sciences, Operations Research & Management Economics, Econometrics & Finance Health Professions Medicine & Pharmacology Public Health
Journal of Health Economic and Policy Research (JHEPR) is a biannual journal published two times a year in January and July by the Center for Health Economics Studies (CHES) Universitas Muhammadiyah Purwokerto (UMP). The journal publishes articles in English. This journal includes multiple focus and scope: - Pharmacy and Pharmaceutical Sciences - Medicine - Economics, Health Economics, and Pharmacoeconomics - Health Policy and Systems - Public Health - Epidemiology and Pharmacoepidemiology - Social, Behavioral, and Administrative Pharmacy.
Arjuna Subject : Profesi Kesehatan - Farmasi
Articles 10 Documents
 1 
Effect of Combination Therapy of Multiple Antihypertensive Drugs with Diuretics on Kidney Function in Congestive Heart Failure Patients Rahmi Yosmar; Surya Dharma; Annisa Nurbuana Putri
Journal of Health Economic and Policy Research (JHEPR) Vol. 1 No. 1 (2023): Journal of Health Economic and Policy Research
Publisher : Center for Health Economic Studies

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.30595/jhepr.v1i1.63

Abstract

Congestive heart failure is the inability of the heart to pump adequate blood that can cause kidney problems. Congestive heart failure causes fluid buildup or edema. This can be overcome by administering diuretics that act on the kidneys by removing fluid retention. This study aims to determine patients' sociodemographic and clinical characteristics and evaluate kidney function in patients receiving antihypertensive combination therapy with diuretics. Method: This research is observational, with a cohort study design and a retrospective approach. Result: The number of samples that met the criteria were 52 patients with sociodemographic characteristics, which were dominated by women as much as 61.5%, aged over 65 years 44.2%, high school education level 55.8%, and worked as IRT (Housewife) 48.1 %. While the clinical characteristics of patients based on length of stay were the most three days 36.5%, and 40-47 kg body weight 19.2%. Of the 52 patients receiving antihypertensive combination therapy with diuretics, 25% (13 people) had normal kidney function, 40% (21 people) had mild kidney impairment, and 35% (18 people) had moderate kidney impairment. Conclusion: based on statistical analysis, antihypertensive drugs with diuretics had no significant effect on kidney function.
Cost-Effectiveness Analysis of the Combination of Metformin-Insulin Glargine and Metformin-Glimepiride in Type 2 Diabetes Mellitus Patients in Rupit Hospital Najmiatul Fitria; Leliani Fitri Anggraini; Yelly Oktavia Sari
Journal of Health Economic and Policy Research (JHEPR) Vol. 1 No. 1 (2023): Journal of Health Economic and Policy Research
Publisher : Center for Health Economic Studies

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.30595/jhepr.v1i1.65

Abstract

Type 2 diabetes mellitus (T2DM) is a chronic disease requiring lifelong care and much money. A combination of antidiabetic drugs aims to increase effectiveness in lowering blood sugar levels. The combination of two drugs consists of a first-line drug class plus another class of drugs with a different mechanism of action. This study aimed to determine the cost-effectiveness of the combination therapy of metformin-insulin glargine and metformin-glimepiride, expressed by the value of the Cost Effectiveness Incremental Ratio (ICER). Method: This research was a descriptive study, and data collection was carried out retrospectively using patient medical record data. This study used a healthcare provider perspective. Of the 406 population, only 102 samples met the inclusion criteria. Result: Fifty-seven records (55.88%) used the metformin-glimepiride combination, and the other forty-five (44.12%) used metformin-insulin glargine. The ICER value of random blood sugar during (RBG) was IDR 21,748.89 for every 1 mg/dL decrease in RBG. The ICER value of fasting blood sugar (FBG) was IDR 38,824.46 for every 1 mg/dL decrease in FBG. Meanwhile, the ICER of HbA1c value was IDR 43,257.46 for every 1% decrease in HbA1c. Conclusion: The three ICER values were in the northeast quadrant (quadrant I), where the metformin-insulin glargine therapy group had the better blood sugar value. Still, the costs required were also higher than the metformin-glimepiride group.
Hypertension and Cholesterol among Late Adults in Indonesia: A Cross-Sectional Population-Based Survey Uzma Eliyanti; Ihsan Hanif
Journal of Health Economic and Policy Research (JHEPR) Vol. 1 No. 1 (2023): Journal of Health Economic and Policy Research
Publisher : Center for Health Economic Studies

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.30595/jhepr.v1i1.70

Abstract

The global prevalence of hypertension is relatively high. In 2012, the death rate due to cardiovascular disease reached 17 million per year, with 45% of the contributors being hypertension. In 2015, globally, cholesterol cases accounted for 4.5% of ischemia of heart disease and 2% of strokes. Until 2017 and 2020, cholesterol disease was mainly experienced by adults aged 20 years or more, with a percentage of 10% of the population. Objective: The purpose of this study was to determine the relationship between hypertension and cholesterol. Methodology: The design study used data from the 5th batch of the Indonesia Family Life Survey (IFLS-5) organized by the Rand Corporation. IFLS-5 was conducted in 2014-2015, with 16,204 households and 50,148 individuals interviewed. Stratified random sampling to select respondents from the province to the place of residence. This study used a cross-sectional study design with inclusion and exclusion criteria from a total of 11,062 respondents. Results: Respondents with late-adult criteria in Indonesia were 50.17% women aged 51.98 (± 9.51), 84.04% married, 22.22% high school graduates, 70.14% Javanese, and 59.88% urban residents. The prevalence of cholesterol in late adults in Indonesia was 8.26% (95% CI: 0.08 – 0.09). The prevalence of hypertension in late adulthood in Indonesia was 20.91% (95% CI: 0.20 – 0.22). The results showed that cholesterol (OR = 4.06, 95% CI 3.53 – 4.67, p = <0.001) was statistically significant with hypertension. Conclusion: The prevalence of hypertension and cholesterol among late adults in Indonesia shows that hypertension and cholesterol are statistically significant and there was a relationship between people suffering from hypertension and having potential cholesterol disease.
Perception Towards Illness/Treatment and Satisfaction Towards Healthcare Services in the Advanced Level Referral Health Facilities Ryan Astaruddin; Dwi Endarti; Tri Murti Andayani; Tuangrat Phodha
Journal of Health Economic and Policy Research (JHEPR) Vol. 1 No. 1 (2023): Journal of Health Economic and Policy Research
Publisher : Center for Health Economic Studies

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.30595/jhepr.v1i1.77

Abstract

Since it was enacted in 2014, it has been reported that the number of JKN participants has increased every year. This increase was influenced by perceptions of illness, perceptions of treatment, and service satisfaction. This study aims to describe perception towards illness/treatment and satisfaction towards satisfaction of health services in the advanced level referral health facility (FKRTL) among national health insurance (JKN) participants and determine the relationship between sociodemographic characteristics and the perceptions and satisfaction. Method: This research is an analytic observational study with a survey data collection using a cross-sectional approach. The study used a convenience sampling technique with a minimum sample size of 400 respondents. The survey was conducted online to cover respondents from all areas of Indonesia. Result: The study showed that 220 respondents (55%) had positive perceptions of illness, 213 respondents (53.2%) had positive perceptions of treatment, meanwhile 217 respondents (54.2%) %) had a satisfied perception of health services. There was a significant relationship between income level and the perception of illness (p=0.048). Conclusion: Most of the respondents have a positive perception of illness and medicine. In addition, some respondents were satisfied with the health services at the advanced-level referral health facility. The income level variable has a significant relationship with the perception of pain.
Perception Towards Illness and Health Care System among Chronic Kidney Patients with Hemodialysis Nurul Adzkia Ghearizky; Tri Murti Andayani; Dwi Endarti; Vo Quang Trung
Journal of Health Economic and Policy Research (JHEPR) Vol. 1 No. 1 (2023): Journal of Health Economic and Policy Research
Publisher : Center for Health Economic Studies

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.30595/jhepr.v1i1.78

Abstract

Chronic kidney disease is still a problem faced by the world of health in Indonesia. The high prevalence of chronic kidney disease has increased every year. The high number of cases of chronic kidney disease causes higher efforts to seek treatment for chronic kidney disease which is influenced by perceptions of disease and perceptions of the health service system. This study aims to determine the illness perception and perception of the service system in chronic kidney patients with hemodialysis at one of the district hospitals in Yogyakarta Province (hospital X). Method: The research method was analytic observational with a cross-sectional approach which was carried out at the hemodialysis polyclinic at hospital X in January-February 2023. The sampling technique used Convenience sampling. Data collection was carried out by direct interviews with respondents using a questionnaire. Data were analyzed using the Kolmogorov-Smirnov test and the Chi-Square test. Result and discussion: The research results obtained a total of 102 respondents. The percentage of respondents with a good illness perception was 66.67% and a good perception of the health service system was 90.19%. Based on the results of the study, it can be concluded that perceptions of disease and perceptions of the health service system for chronic kidney patients with hemodialysis at Hospital X tend to be good. Conclusion: The results of statistical tests showed that there was no relationship between gender, age, duration of chronic kidney disease, education level, and family income on perceptions of disease and perceptions of the health service system at Hospital X, Special Region of Yogyakarta.
Cost Analysis Of Type 2 Diabetes Mellitus Therapy In High-Income And Low And Middle-Income Countries: A Systematic Review Raihana Nurul Izzah; Dwi Endarti; Tri Murti Andayani
Journal of Health Economic and Policy Research (JHEPR) Vol. 4 No. 1 (2026): Journal of Health Economic and Policy Research
Publisher : Universitas Muhammadiyah Purwokerto

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.30595/jhepr.v4i1.202

Abstract

Abstract Introduction: Diabetes is currently a very serious health problem. There is an increase in the prevalence and incidence of type 2 diabetes mellitus, this disease causes suffering for sufferers and also causes the death of a person, which makes a large economic burden for both the community and health care facilities. This study aimed to analyze the total direct medical costs of type 2 diabetes mellitus therapy in high-income, low- and middle-income countries. Methods: A systematic review was carried out following the PRISMA guidelines. The article search method was carried out by searching PubMed, ScienceDirect, and Springer for articles that analyzed the total direct medical costs of type 2 diabetes mellitus therapy. Nine articles are considered important to be discussed in this review, these nine articles were published between January 2014 and December 2023. Result: The results showed that the two components that had the greatest impact on the direct medical costs of managing type 2 diabetes were inpatient services and medications. Direct medical costs ranged from the lowest to the highest at $343,93 for the Kenya study to $5.090,48 for the Spain study, while medication costs ranged from $34,23 for Indonesia to $645,52 for Bangladesh from the average annual direct costs per person. The most widely used drugs were oral hypoglycemic drugs, while the most expensive drugs were Combination of Oral and Insulin. Complications of diabetes resulted in increased expenditure of the total direct medical costs. Conclusion: This review concludes that the studies reviewed indicate a considerable health financing burden in the care of type 2 diabetes mellitus. Efforts to prevent diabetes complications have the possibility of saving the cost of diabetes care.
COST EFFECTIVENESS ANALYSIS OF LETROZOLE VERSUS TAMOXIFEN IN EARLY-STAGE BREAST CANCER FOR POSTMENOPAUSAL WOMEN: SYSTEMATIC REVIEW Lucia Shinta Ratnaningtyas; Prof.Dr. Tri Murti Andayani, Sp.FRS; Dr. apt. Dwi Endarti, S.F., M.Sc.
Journal of Health Economic and Policy Research (JHEPR) Vol. 4 No. 1 (2026): Journal of Health Economic and Policy Research
Publisher : Universitas Muhammadiyah Purwokerto

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.30595/jhepr.v4i1.301

Abstract

ABSTRACT Background:Breast cancer remains a major global health challenge, not only because of its clinical implications but also due to the increasing financial burden associated with its treatment. As such, cost-effectiveness analysis (CEA) plays a crucial role in supporting evidence-based decisions that optimize the use of healthcare resources. In postmenopausal women diagnosed with hormone receptor-positive early breast cancer, tamoxifen and letrozole are frequently prescribed endocrine therapies. Although letrozole has demonstrated superior efficacy in lowering recurrence rates and enhancing survival outcomes, its use is accompanied by higher treatment costs and a distinct profile of adverse effects. Objectives:This review aims to systematically examine and integrate current findings on the cost-effectiveness of letrozole versus tamoxifen in treating early-stage breast cancer in postmenopausal patients. Methods:A structured literature review was conducted in April 2025 across three major academic databases: PubMed, ScienceDirect, and SpringerLink. The selected studies were assessed for methodological rigor and potential bias using the CHEERS checklist. Five publications met the eligibility criteria and were included for data extraction and analysis. Results:All included studies reported that letrozole provided greater clinical benefit compared to tamoxifen in terms of reducing recurrence and extending disease-free survival in the target population. However, these clinical gains were linked to increased treatment costs and a unique spectrum of side effects. While letrozole was associated with a higher risk of bone and cardiovascular events, it posed a lower risk of endometrial cancer and thromboembolism than tamoxifen. Economic evaluations from various countries—namely China, Canada, the USA, the UK, and Germany—consistently found that letrozole led to greater quality-adjusted life years (QALYs). Moreover, its incremental cost-effectiveness ratios (ICERs) generally remained within acceptable national thresholds. Conclusion:For postmenopausal women undergoing adjuvant treatment for early-stage hormone receptor-positive breast cancer, letrozole offers a cost-effective alternative to tamoxifen. Despite its higher direct costs, its improved clinical efficacy supports its broader adoption in diverse healthcare systems. Keywords: Letrozole, Tamoxifen, Cost-effectiveness, Early-Stage Breast Cancer, Postmenopausal.
Comparative Analysis of Drug Policy Prices and National Procurement Systems in Universal Health Coverage Erlisa Irawati Putri; Chairun Wiedyaningsih; Roshinta Andien Damayanti
Journal of Health Economic and Policy Research (JHEPR) Vol. 4 No. 1 (2026): Journal of Health Economic and Policy Research
Publisher : Universitas Muhammadiyah Purwokerto

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.30595/jhepr.v4i1.352

Abstract

Background: Access to affordable essential medicines is a key prerequisite for achieving Universal Health Coverage (UHC), particularly in developing countries facing fiscal pressures and pharmaceutical market inefficiencies. However, the effectiveness of medicine pricing policies varies significantly between countries, depending on regulatory design, procurement capacity, and political commitment to universal access. Aims: This study aims to analyse and compare drug pricing policies and national procurement systems in five Asian countries—Indonesia, the Philippines, Thailand, Malaysia, and India—in the context of UHC. Methods: This study employs a comparative policy analysis approach, utilising secondary data from national regulations, official government reports, and academic literature. Results: Thailand has demonstrated the most effective model, combining HTA, compulsory licensing, and a centralized GPO system, which reduces drug prices by up to 90%. India optimises generic procurement through the Jan Aushadhi programme, while Malaysia combines external price references with tiered enforcement policies. In contrast, Indonesia and the Philippines still face challenges in price compliance and distribution efficiency, due to institutional fragmentation and weak oversight. Conclusion: This study underscores the importance of integrating robust regulatory strategies, effective procurement mechanisms, and rigorous monitoring systems to ensure affordability and equitable access to medicines. Cross-country learning can strengthen national pharmaceutical reforms and support policy integration in the ASEAN region. Keywords: Drug prices, UHC, pharmaceutical procurement, Asian pharmaceutical policy.
Optimization of Boiling Time for Maximum Curcuminoid Yield in a Traditional Turmeric Tamarind Jamu Using UV-Vis Spectrophotometry: Optimasi Waktu Perebusan untuk Hasil Kurkuminoid Maksimum dalam Jamu Kunyit Asam Jawa Tradisional Menggunakan Spektrofotometri UV-Vis aditya raharjo
Journal of Health Economic and Policy Research (JHEPR) Vol. 4 No. 1 (2026): Journal of Health Economic and Policy Research
Publisher : Universitas Muhammadiyah Purwokerto

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.30595/jhepr.v4i1.378

Abstract

Introduction: Turmeric tamarind herbal drink (Jamu Kunyit Asam) is a popular traditional medicine in Indonesia, valued for the health benefits of curcuminoids from turmeric. However, traditional preparation methods, particularly boiling time, are not standardized, potentially leading to inconsistent curcuminoid content, which affects efficacy. Objective: This study aimed to determine the effect of boiling time on the curcuminoid content in Jamu Kunyit Asam and to identify the optimal boiling time to achieve the maximum concentration. Methods: Fresh curcuma rhizomes (Curcuma longa L.) and tamarind fructus (Tamarindus indica L.) were boiled at 90 ± 2°C. Samples were collected at 5, 10, 15, 20, and 30-minute intervals. Curcuminoids were isolated using liquid-liquid extraction with chloroform and quantified using a validated UV-Vis spectrophotometry method at a maximum wavelength of 423 nm. Results: The analytical method was validated and showed excellent linearity (r = 0.9997), accuracy (92% recovery), and precision (%RSD = 0.89). The results demonstrated a non-linear relationship between boiling time and curcuminoid content. The concentration increased sharply to a peak of 57.602 ppm at the 10-minute mark, followed by a consistent decrease to 24.576 ppm by 30 minutes. Conclusion: The optimal boiling time for maximizing curcuminoid content in Jamu Kunyit Asam is 10 minutes at 90°C. Boiling for less than 10 minutes results in incomplete extraction, while boiling longer leads to significant thermal degradation of curcuminoids. This finding provides a scientific basis for standardizing the preparation of this traditional herbal medicine to ensure optimal bioactive compound content.
Cost-Effectiveness Analysis of Rifampicin and Bedaquiline Use for Tuberculosis Treatment: A Systematic Review wawang anwarudin
Journal of Health Economic and Policy Research (JHEPR) Vol. 4 No. 1 (2026): Journal of Health Economic and Policy Research
Publisher : Universitas Muhammadiyah Purwokerto

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.30595/jhepr.v4i1.442

Abstract

Introduction: Multidrug-resistant tuberculosis (MDR-TB), particularly rifampicin-resistant tuberculosis (RR-TB), remains a major challenge to global tuberculosis control and imposes substantial economic burdens on healthcare systems. Since 2020, the World Health Organization (WHO) has recommended the use of bedaquiline, a novel oral anti-tuberculosis drug, as part of an all-oral shorter regimen for the treatment of MDR-TB. This recommendation aims to improve treatment outcomes while reducing treatment duration and toxicity associated with conventional regimens. Materials and Methods: This study employed a systematic review approach of peer-reviewed articles published between 2020 and 2026. A total of 14 studies were included in the analysis. The selected studies evaluated cost-effectiveness outcomes such as direct medical costs, quality-adjusted life years (QALYs), and incremental cost-effectiveness ratios (ICERs). Various pharmacoeconomic modeling methods were applied in the included studies, including Markov models, decision tree analyses, and randomized controlled trials. Result: Most of the reviewed studies reported that bedaquiline-based regimens are more cost-effective compared with conventional rifampicin-based therapy. The ICER values were generally below the national willingness to pay thresholds, indicating favorable economic value. In several studies, bedaquiline-based regimens even demonstrated cost-saving potential. In particular, the BPaL regimen (bedaquiline, pretomanid, and linezolid) showed shorter treatment duration, improved clinical outcomes, and lower relapse and resistance rates. Conclusion: Bedaquiline represents a clinically effective and economically efficient treatment option for MDR-TB. Its implementation should be prioritized in national tuberculosis control programs, especially in low and middle income countries with a high TB burden. Further real-world implementation studies are necessary to support broader integration into healthcare systems. Keywords: Bedaquiline, cost-effectiveness, MDR-TB, rifampicin, ICER

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