Article Sidebar

Submitted
Mar 22, 2025
Published
Aug 31, 2025
Download
Statistic
Read Counter : 28

Downloads

Download data is not yet available.

Main Article Content

Abstract

Type 2 diabetes mellitus, often accompanied by comorbid hypertension, necessitates expensive and prolonged treatment. Therefore, conducting a cost-effectiveness analysis is crucial to identify the most economically viable option by comparing the costs and therapeutic efficacy of amlodipine and candesartan in patients with type 2 diabetes mellitus and comorbid hypertension in Yogyakarta, Indonesia. This research aims to analyze therapy costs and effectiveness using pharmacoeconomic assessment, specifically calculating ACER (Average Cost-Effectiveness Ratio) and ICER (Incremental Cost-Effectiveness Ratio) values. The study uses a quantitative approach with retrospective data collection from patient medical records through total sampling. This research gathered data from 149 medical records. The cost-effectiveness analysis based on ACER values revealed the following: amlodipine 5 mg cost IDR 86; amlodipine 10 mg cost IDR 51; candesartan 8 mg cost IDR 571; candesartan 16 mg cost IDR 727. The ICER value of amlodipine 5 mg – candesartan 8 mg cost IDR 1,527; amlodipine 5 mg – candesartan 16 mg cost IDR 2,192; amlodipine 10 mg – candesartan 8 mg cost IDR –8454; amlodipin 10 mg – candesartan 16 mg cost IDR –5,979. The therapy is considered cost-effective when the ACER value is low, and the negative value of ICER indicates that the treatment has lower costs with greater effectiveness. So, using amlodipine 10 mg is the most cost-effective approach for reducing blood pressure in type 2 diabetes mellitus patients with comorbid hypertension in Yogyakarta, Indonesia.


 

Keywords

Amlodipine Candesartan Cost effective Hypertension Type 2 diabetes mellitus

Article Details

Creative Commons License

This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.

References

  1. ADA. (2022). Professional Practice Committee: Standards of Medical Care in Diabetes—2022. THE JOURNAL OF CLINICAL AND APPLIED RESEARCH AND EDUCATION DIABETES CARE, 45(January), S3. https://doi.org/10.2337/dc22-SPPC
  2. Ahadiah, N., Handayani, N., & Suhardiana, E. (2020). Evaluation of Drug Suitability and Dosage of Antihypertensive Drugs in the Outpatient Installation of Hospital X in Tasikmalaya City. Information Media, 15(2), 129–137. https://doi.org/10.37160/bmi.v15i2.409
  3. Akbar, D. O., Yaumil, F., & Setiawan, A. A. (2024). Analisis Efektivitas Biaya Pengobatan Hipertensi Pada Pasien Rawat Jalan Di Klinik Nurul Hasanah Tahun 2022. Jurnal Insan Farmasi Indonesia, 6(3), 9–17. https://doi.org/10.36387/jifi.v6i3.1691
  4. Anggraini, D. W., Nurmainah, N., & Rizkifani, S. (2023). Analisis Efektivitas Biaya Antihipertensi Amlodipin Tunggal dan Kombinasi pada Pasien Hipertensi dengan Diabetes Melitus Tipe II Rawat Jalan di Rumah Sakit di Kota Pontianak. Jurnal Pharmascience, 10(2), 329. https://doi.org/10.20527/jps.v10i2.16014
  5. Arum, Y. T. G. (2019). Hipertensi pada Penduduk Usia Produktif (15-64 Tahun). Higeia Journal of Public Health Research and Development, 1(3), 84–94.
  6. Baroroh, F., & Sari, A. (2018). Cost Effectiveness Analysis Therapy Combination of Candesartan-Amlodipine and Candesartan-Diltiazem on Hypertensive Outpatients. PHARMACY: Jurnal Farmasi Indonesia (Pharmaceutical Journal of Indonesia), 14(2), 188. https://doi.org/10.30595/pharmacy.v14i2.1952
  7. Bhavya, E., & Sanjay, G. (2022). Diabetes and the importance of insulin. International Journal of Health Sciences, 6(April), 8479–8487. https://doi.org/10.53730/ijhs.v6ns1.6844
  8. BPJS. (2017). Tangkis Resiko Kardiometabolik dengan Optimalisasi PROLANIS. https://www.bpjs-kesehatan.go.id/bpjs/index.php/post/read/2017/ 536/Avoid-Cardiometabolic-by-Optimalized-PROLANIS.
  9. Cahyaningsih, I., Hikmah, N., & Maziyyah, N. (2023). Drug-related problems in elderly patients with diabetes: A study in primary health care setting. Journal of Advanced Pharmacy Education and Research, 13(2), 29–34. https://doi.org/10.51847/RgpUP8AeB3
  10. Cahyaningsih, I., & Wicaksono, W. A. (2020). Penilaian Risiko Interaksi Obat pada Pasien dengan Diabetes Melitus Tipe 2. Indonesian Journal of Clinical Pharmacy, 9(1), 9. https://doi.org/10.15416/ijcp.2020.9.1.9
  11. Candra, A., Santi, T. D., Yani, M., & Mawaddah, D. S. (2022). Faktor-Faktor yang Berhubungan dengan Kejadian Hipertensi di Desa Baet Lampuot Aceh Besar. Media Kesehatan Masyarakat Indonesia, 21(6), 418–423. https://doi.org/10.14710/mkmi.21.6.418-423
  12. Chrisniati, E., Marchira, C. R., & Kusnanto, H. (2017). Depresi dan kualitas hidup pasien diabetes mellitus tipe 2 di rumah sakit Sardjito Yogyakarta. Berita Kedokteran Masyarakat, 33(3), 141–146. https://jurnal.ugm.ac.id/bkm/article/view/12608
  13. De Boer, I. H., Bangalore, S., Benetos, A., Davis, A. M., Michos, E. D., Muntner, P., Rossing, P., Zoungas, S., & Bakris, G. (2017). Diabetes and hypertension: A position statement by the American diabetes association. Diabetes Care, 40(9), 1273–1284. https://doi.org/10.2337/dci17-0026
  14. Dedefo, A., Galgalo, A., Jarso, G., & Mohammed, A. (2018). Prevalence of Hypertension and Its Management Pattern among Type 2 Diabetic Patients Attending, Adama Hospital Medical College, Adama, Ethiopia. Journal of Diabetes & Metabolism, 9(10). https://doi.org/10.4172/2155-6156.1000808
  15. Dedullah, R. F., Malonda, N. S. H., Joseph, W. B. S., & et al. (2015). The Relationship between Hypertension Risk Factors and the Incidence of Hypertension in the Community of Motoboi Kecil Village, South Kotamobagu Subdistrict, Kotamobagu City. Jurnal Kesmas, 4(2), 111–118.
  16. Fautrel, B., Boonen, A., De Wit, M., Grimm, S., Joore, M., & Guillemin, F. (2020). Cost assessment of health interventions and diseases. RMD Open, 6(3), 1–6. https://doi.org/10.1136/rmdopen-2020-001287
  17. Kemenkes. (2020). Infodatin remains productive, prevent, and address Diabetes Mellitus 2020. In Data and Information Center of the Indonesian Ministry of Health (pp. 1–10).
  18. Laloan, M. M. C., Tiwow, G. A. R., Palandi, R. R., & Tumbel, S. L. (2019). Analisis Efektivitas Biaya Terapi Antihipertensi Kombinasi AmlodipinBisoprolol Dibandingkan Kombinasi Amlodipin-Captopril Pada Pasien Rawat Inap Di Rumah Sakit Gunung Maria Tomohon. Biofarmasetikal Tropis, 2(2), 85–89. https://doi.org/10.55724/jbiofartrop.v2i2.119
  19. Madania, Bangol, A., & Diantika, A. (2022). Cost-effectiveness analysis of therapy in patients with hypertension and type 2 diabetes mellitus at the outpatient clinic of Toto Kabila Regional General Hospital. Jambura Journal of Health Sciences and Research, 4(1), 426–442.
  20. Mazaya, S. ., Rifkia, V., & Chairani, A. (2020). Perbandingan Penurunan Tekanan Darah Pasien Hipertensi Intradialisis Dengan Obat Antihipertensi Amlodipin dan Kaptopril di RS Bhayangkara TK. I R. Said Sukanto. Jurnal Farmasi Udayana, 9(2), 83. https://doi.org/10.24843/jfu.2020.v09.i02.p03
  21. Nurhikma, E., Wulaisfan, R., & Musdalipah, M. (2019). Cost Effectiveness of Combination Antihypertensive Candesartan-Bisoprolol and Candesartan-Amlodipine in Outpatient Hypertensive Patients. Medical Profession Journal: Journal of Medicine and Health, 13(2), 54–61. https://doi.org/10.33533/jpm.v13i2.1284
  22. Orbayinah, S., Hikmah, N., Arviani, S. D., Hidayah, F. N., Soularto, D. S., Cahyaningsih, I., Romdzati, Hadning, I., Ghozali, M. T., Pamungkas, K. A., & Utami, P. (2024). BersaMaDia App for Improving Quality of Life in Type 2 Diabetes Mellitus Patients at Asri Medical Center Muhammadiyah Hospital Yogyakarta. BIO Web of Conferences, 135. https://doi.org/10.1051/bioconf/202413502002
  23. Pahlevi, R. (2021). The Fifth Largest Diabetes Population in the World is in Indonesia. Article, 1.
  24. Park, C., Wang, G., Durthaler, J. M., & Fang, J. (2017). Cost-effectiveness Analyses of Antihypertensive Medicines: A Systematic Review. American Journal of Preventive Medicine, 53(6), S131–S142. https://doi.org/10.1016/j.amepre.2017.06.020
  25. Perawati, S., Andirani, M., & Utaka, T. (2021). Cost-effectiveness analysis of amlodipine and candesartan hypertension medication usage in inpatient BPJS patients at Dr. Bratanata Hospital. Pharma Xplore, 6(2), 47–54.
  26. Refasi, N. L., Lolo, W. A., & Bodhi, W. (2018). Analisis Efektivitas Biaya (Cost Effectiveness Analysis) pada Pengobatan Pasien Malaria Falciparum di RSUD Nabire. Pharmacon, 7(2), 1–9.
  27. Restyana, A. Probosiwi, N. (2018). Cost-Effectiveness Analysis of Oral Antihypertensive Candesartan and Amlodipine in Inpatient Hypertensive Patients at X Hospital Kediri. Photosynthetica, 2(1), 1–13.
  28. Riannur, T., Syamsul, E. S., Sentat, T., Tinggi, S., & Samarinda, I. K. (2020). Analisis Biaya Minimal Candesartan Dibandingkan Amlodipin Pada Pasien Hipertensi Rawat Jalan Di Rs “X” Kota Samarinda. Prosiding Sekolah Tinggi Ilmu Kesehatan Samarinda, 1, 94–103.
  29. Stiadi, D. R., Andrajati, R., & Trisna, Y. (2020). Cost-effectiveness Analysis of Combination Therapy Amlodipine-Kandesartan and Amlodipine-Ramipril in Outpatient Hypertensive Patients with Type 2 Diabetes Complications at Dr. Cipto Mangunkusumo National Central General Hospital. Indonesian Journal of Clinical Pharmacy, 9(4), 271. https://doi.org/10.15416/ijcp.2020.9.4.271
  30. Unger, T., Borghi, C., Charchar, F., Khan, N. A., Poulter, N. R., Prabhakaran, D., Ramirez, A., Schlaich, M., Stergiou, G. S., Tomaszewski, M., Wainford, R. D., Williams, B., & Schutte, A. E. (2020). 2020 International Society of Hypertension Global Hypertension Practice Guidelines. Hypertension, 75(6), 1334–1357. https://doi.org/10.1161/HYPERTENSIONAHA.120.15026
  31. Wardani, A. A. K., & Yuswantina, R. (2023). Analisis Efektivitas Biaya Penggunaan Obat Hipertensi Amlodipin dan Candesartan pada Pasien Hipertensi di Klinik Merah Putih Ungaran. Journal of Holistics and Health Sciences, 5(2), 414–420.
  32. Whelton, P. K., Carey, R. M., Aronow, W. S., Casey, D. E., Collins, K. J., Himmelfarb, C. D., DePalma, S. M., Gidding, S., Jamerson, K. A., Jones, D. W., MacLaughlin, E. J., Muntner, P., Ovbiagele, B., Smith, S. C., Spencer, C. C., Stafford, R. S., Taler, S. J., Thomas, R. J., Williams, K. A., Hundley, J. (2018). 2017 ACC/AHA/AAPA/ABC/ACPM/AGS/APhA/ ASH/ASPC/NMA/PCNA guideline for the prevention, detection, evaluation, and management of high blood pressure in adults a report of the American College of Cardiology/American Heart Association Task Force on Clinical pr. In Hypertension (Vol. 71, Issue 6). https://doi.org/10.1161/HYP.0000000000000065
  33. WHO. (2019). Classification of Diabetes Melitus. Genneva, License(CC BY-NCSA), 3.0.
  34. WHO. (2021). Guideline for the pharmacological treatment of hypertension in adults (Issue December).
  35. Wulandari, T. (2019). Pattern of Combination Use of Two Antihypertensive Drugs in Hypertensive Patients. ILKES Journal (Journal of Health Sciences), Volume 10(1), 80.