Analisis Cost-Effectiveness Seftazidim Generik pada Pasien Kanker Payudara di Rumah Sakit Kanker “Dharmais” Jakarta, 2012


DOI : 10.33371/ijoc.v10i3.439

Administration of ceftazidime shortened duration of neutropenia and hospitalization days in breast cancer patients who had infection after myelosupressive chemotherapy. Cost-effectiveness analysis (CEA) as one of pharmacoeconomic methods was important to determine treatment attaining effect for lower cost. The aim of this study was to compare
the total direct medical cost and effectiveness, which was measured from length-of-stay (LOS), of generic ceftazidime A and B usage, and to decide which ceftazidime that was more cost-effective in early-stage and late-stage breast cancer patients at National Cancer Center Dharmais Hospital Jakarta year 2012. The study design was non-experimental with
comparative study retrospectively on secondary data from medical records and administrative data in 2012. Samples were taken by using total sampling method. The number of samples were 9 patients, which included 7 patients with generic ceftazidime A and 2 patients with generic ceftazidime B. The total direct medical cost of generic ceftazidime A in early-stage and late-stage breast cancer patients, respectively Rp 15.930.407,45 and Rp 15.962.519,25, were higher than generic B, respectively Rp 6.716.225,21 and Rp 7.147.956,92. Median LOS of generic A ceftazidime in early-stage and late-stage breast cancer patients, respectively 7 days and 10 days, were longer than generic B, respectively 3 days and 4 days. According to CEA result, generic ceftazidime B was more cost-effective than generic A.

Pemberian seftazidim dapat mempersingkat durasi neutropenia dan lama hari rawat inap pada pasien kanker payudara yang mengalami infeksi setelah kemoterapi mielosupresif. Analisis cost-effectiveness merupakan salah satu metode farmakoekonomi yang penting untuk menentukan obat efektif dengan biaya yang lebih rendah. Penelitian dilakukan untuk membandingkan total biaya medis langsung dan efektivitas yang dilihat dari lama hari rawat penggunaan seftazidim generik A dan B, serta menentukan seftazidim yang lebih cost-effective pada pasien kanker payudara stadium awal dan lanjut di Rumah Sakit Kanker “Dharmais” Jakarta, 2012. Desain penelitian yang digunakan adalah studi komparatif secara retrospektif terhadap data rekam medis dan administrasi tahun 2012. Pengambilan sampel dilakukan secara total sampling. Jumlah pasien yang dilibatkan dalam analisis 9 pasien, yaitu 7 pasien menggunakan seftazidim generik A dan 2 pasien menggunakan seftazidim generik B. Median total biaya medis langsung kelompok generik A pada pasien kanker stadium awal maupun lanjut berturut-turut sebesar Rp 15.930.407,45 dan Rp 15.962.519,25 lebih tinggi dibanding generik B, berturut-turut sebesar Rp 6.716.225,21 dan Rp 7.147.956,92. Median lama hari rawat kelompok generik A pada pasien kanker stadium awal maupun lanjut berturut-turut 7 hari dan 10 hari, lebih panjang dibanding generik B, berturut-turut 3 hari dan 4 hari. Berdasarkan hasil penelitian disimpulkan bahwa seftazidim generik B lebih cost-effective dibanding generik A.

breast cancer; ceftazidime; cost-effectiveness; generic; infection
  1. Hadinegoro, Sri Rezeki S. Demam pada Pasien Neutropenia. Sari Pediatri
  2. ;3:35-241.
  3. Egerer et al. Continuous infusion of ceftazidime for patients with breast cancer and
  4. multiple myeloma receiving high-dose chemotherapy and peripheral blood stem cell
  5. transplantation. Bone MarrowTransplant 2002;30:427-431.
  6. Rascati, K.I., Drummond, M.F., Annemans, I. & Davey, P.G. Education in
  7. Pharmacoeconomics: an Internasional Multidiciplinary View (Review). Pharmaco
  8. Economics 2004;22:39-47.
  9. Walley, Tom. Pharmacoeconomics and Economic Evaluation of Drug Therapies (pp.
  10. -73). UK: Liverpool, 2004
  11. Honneycutt, A.A, et al. Guide to Analyzing the Cost-Effectiveness of Community
  12. Public Health Prevention Approaches (pp. 56-57). USA: Research Triangle Park, 2006.
  13. David, E., et al. Decision Analysis of Antibiotic and Diagnostic Strategies in Ventilator-
  14. associated Pneumonia. American Journal of Respiratory and Critical Care Medicine
  15. ;168(9):1060-1067. Polednak, A.P. Surveillance for hospitalizations with
  16. infectionrelated diagnoses after chemotherapy among breast cancer patients
  17. diagnosed before age 65. Chemotherapy 2004;50(4): 157-161.
  18. Adams, J.R., Angelotta, C., & Bennet, C. When the Risk of Febrile Neutropenia Is 20%,
  19. Prophylactic Colony-Stimulating Factor Use Is Clinically Effective, but Is It
  20. Cost-Effective. JCO 2006;24(19):2975-2977.
  21. Nani, Desiyani. Hubungan Umur Awal Menopause dan Status Penggunaan
  22. Kontrasepsi Hormonal dengan Kejadian Kanker Payudara. Jurnal Keperawatan
  23. Soedirman The Soedirman Journal of Nursing 2009;4(3):102-106.
  24. Pasko, M.T., Beam, T.R., Sponer, J.A. & Camara, D.S. Safety and pharmacokinetics of
  25. ceftazidime in patients with chronic hepatic dysfunction. J Antimicrob Chemother
  26. ;15(3):365-374.
  27. Ballot, J., McDonnel, D., & Crown, J. Successful Treat ment of Thrombocytopenia
  28. Due to Marrow Metastases of Breast Cancer with Weekly Docetaxel. J Natl Cancer
  29. Inst 2003;95(11):831-832.
  30. Oliver, T.B., Bhat,R., Kellet, C.F. & Adamson, D.J. Diagnosis and management of bone
  31. metastases. JR CollPhysicians 2011;41:330–338
  32. Aapro, et al. 2010 update of EORTC guidelines for the use of granulocytecolony
  33. stimulating factor to reduce the incidence of chemotherapy-induced febrile
  34. neutropenia in adult patients with lymphoproliferative disorders and solid tumours.
  35. European Journal of Cancer 2010; 47: 8–32.
  36. National Comprehensive Cancer Network. (2013). NCCN Clinical Practice
  37. Guideline Oncology: Myeloid Growth Factors.Februari 8, 2013.
  38. http://www.nccn.orgGunawan, S.G., (Ed.). Farmakologi dan Terapi edisi 5 (pp. 593,
  39. -686). Jakarta: Fakultas Kedokteran Universitas Indonesia, 2007
  40. Skeel, R.T. (Ed.). Handbook of Cancer Chemotherapy (pp.634-665). USA: Lippincott
  41. Williams & Wilkins; 2008.
  42. Chisholm-Burns et al (Eds.). Pharmacotherapy: Principles and Practice (pp. 1297,
  43. -1321). New York : McGraw-Hill, 2008.
  44. Hai Pun, E., et al. Cancer Patients with Fever and Neutropenia: A Prospective
  45. Evaluation of Risk Assessment Tools and Infectious Etiology in Hong Kong (pp. 5).
  46. Hongkong : Health and Health Services Research Fund, 2009.

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Submitted: 2016-11-18
Published: 2016-11-18
Section: Research Articles
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