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Comparison of direct medical cost between ramipril and candesartan in hospitalized acute decompensated heart failure at West Nusa Tenggara Regional Hospital

Abstract

Introduction: Pharmacoeconomy is the field of study regarding costs analysis associated with the use of drugs in health care. The purpose of pharmacoeconomics is to compare a different drug used in the treatment with the same condition or can be the opposite, i.e. comparing different treatments in different circumstances. The purpose of this study is to determine and compare the average efficiency of direct medical costs between ramipril and candesartan combination drug in hospitalized heart failure patients with a payer perspective at the West Nusa Tenggara Regional General Hospital, Mataram, Indonesia.

Method: This study is part of an economic evaluation of direct medical cost analysis research in hospitalized heart failure patients with a payer perspective. Study design using a retrospective approach involving 45 patients with heart failure who met the study inclusion criteria and exclusion criteria. Independent t-test was used to compare the direct medical cost between ramipril and candesartan.

Results: The average gross total cost of using ramipril combination was Rp. 4,197,011 while the average total cost of using candesartan combination was Rp. 3,099,088. These results indicate there are savings in the average total cost of treatment for heart failure using candesartan that is Rp. 1,097,923. Candesartan combination provides the lowest value and is a more efficient choice compared to ramipril combination. Meanwhile, after t-test comparison reveal no significant different average direct medical costs in patients using the ramipril combination compared with the candesartan combination (p>0.05).

Conclusion: The results of this study indicate that there is no significant difference between the average direct medical costs in patients using ramipril compared with candesartan combination.

References

  1. Dickstein K, Cohen-Solal A, Filippatos G, McMurray JJ, Ponikowski P, Poole-Wilson PA, et al. ESC guidelines for the diagnosis and treatment of acute and chronic heart failure 2008: the task force for the diagnosis and treatment of acute and chronic heart failure 2008 of the European Society of Cardiology. Developed in collaboration with the heart failure association of the ESC (HFA) and endorsed by the European Society of Intensive Care Medicine (ESICM). Eur Heart J. 2008;29(19):2388–442.
  2. Go AS, Mozaffarian D, Roger VL, Benjamin EJ, Berry JD, Blaha MJ, et al. Heart disease and stroke statistics–2014 update: a report from the American Heart Association. Circulation. 2014;129(3):e28–e292.
  3. Ponikowski P, Voors AA, Anker SD, et al. 2016 ESC guidelines for the diagnosis and treatment of acute and chronic heart failure: the task force for the diagnosis and treatment of acute and chronic heart failure of the European Society of Cardiology (ESC) developed with the special contribution of the Heart Failure Association (HFA) of the ESC. Eur Heart J. 2016;37:2129-2200.
  4. Kim MS, Lee JH, Kim EJ, et al. Korean guidelines for diagnosis and management of chronic heart failure. Korean Circ J. 2017;47:555-643.
  5. Youn JC, Han S, Ryu KH. Temporal trends of hospitalized patients with heart failure in Korea. Korean Circ J. 2017;47:16-24.
  6. Aimin Shi, Ziqi Tao, Peng Wei, Jing Zhao. Epidemiological aspects of heart diseases. Exp Ther Med. 2016;12(3):1645–1650.
  7. Mosterd A, Hoes AW. Clinical epidemiology of heart failure. Heart 2007;93:1137-1146.
  8. Owan TE, Hodge DO, Herges RM, Jacobsen SJ, Roger VL, Redfield MM. Trends in prevalence and outcome of heart failure with preserved ejection fraction. N Engl J Med. 2006;355:251-259.
  9. Lee JH, Lim NK, Cho MC, Park HY. Epidemiology of heart failure in Korea: present and future. Korean Circ J. 2016;46:658-664
  10. World Health Organization. Cardiovascular Diseases. Available at: https://www.who.int/health-topics/cardiovascular-diseases/#tab=tab_1 .
  11. Bui LB, Horwich TB, Fonarow GC. Epidemiology and risk profile of heart failure, Nature Reviews Cardiology. 2011;8:30-41.
  12. Liao L, Allen LA, Whellan DJ. Economic burden of heart failure in the elderly. Pharmaco Economics. 2008;26(6):447–62.
  13. Cook C, Cole G, Asaria P, Jabbour R, Francis DP. The annual global economic burden of heart failure. Int J Cardiol. 2014;171(3):368–76.
  14. Reed SD, Whellan DJ, Li Y, Friedman JY, Ellis SJ, Pina IL, et al. Economic evaluation of the HF-ACTION (heart failure: a controlled trial investigating outcomes of exercise training) randomized controlled trial: an exercise training study of patients with chronic heart failure. Circulation Cardiovascular quality and outcomes. 2010;3(4):374–81.
  15. Bundkirchen A, Schwinger RHG. Epidemiology and economic burden of chronic heart failure. European Heart Journal, Supplement. 2004;6(D):D57–60.
  16. Pocock SJ, Ariti CA, McMurray JJ, Maggioni A, Kober L, Squire IB, et al. Predicting survival in heart failure: a risk score based on 39 372 patients from 30 studies. Eur Heart J. 2013;34(19):1404–13
  17. Drummond M, Sculpher M, Claxton K, Stoddart G, Torrance G. Methods for The Economic Evaluation of Health Care Programmes. 4thth ed. 2015.
  18. Cameron D, Ubels J, Norstrom F. On what basis are medical cost-effectiveness thresholds set? Clashing opinions and an absence of data: a systematic review. Global Health Action. 2018;11(1):1447828.
  19. Hong-Mi Choi, Myung-Soo Park2, and Jong-Chan Youn. Update on heart failure management and future directions. Korean J Intern Med. 2019;34:11-43.
  20. Lawson CA, Solis-Trapala I, Dahlstrom U, Mamas M, Jaarsma T, Kadam UT, et al. (2018) Comorbidity health pathways in heart failure patients: A sequences-of-regressions analysis using cross-sectional data from 10,575 patients in the Swedish Heart Failure Registry. PLoS Med 15 (3): e1002540. https://doi.org/10.1371/journal. pmed.1002540
  21. Rahmawati C, Nurwahyuni A. Analysis of the Minimal Cost of Antihypertensive Medication between the Combination of Ramipril-Spironolactone with Valsartan in Congestive Heart Failure Patients at XY Hospital in Jakarta in 2014. Journal of Indonesian Health Economics. 2017:1(4):191-200.
  22. Schädlich PK, Huppertz E, Brecht JG. Cost-effectiveness analysis of ramipril in heart failure after myocardial infarction. Economic evaluation of the Acute Infarction Ramipril Efficacy (AIRE) study for Germany from the perspective of Statutory Health Insurance. Pharmacoeconomics. 1998;14(6):653-669. doi:10.2165/00019053-199814060-00006.
  23. Baroroh F, Sari A, Masruroh N. Cost Effectiveness Analysis of Candesartan Therapy in Comparison to Candesartan-Amlodipine Therapy on Hypertensive Outpatients. Open Access Maced J Med Sci. 2019;7(22):3837-3840. Published 2019 Nov 14. doi:10.3889/oamjms.2019.515

How to Cite

Qiyaam, N., Nopitasari, B. L., Nopitasari, B. L., Rahmawati, C., Nurbaety, B., & Pratiwi, E. A. (2020). Comparison of direct medical cost between ramipril and candesartan in hospitalized acute decompensated heart failure at West Nusa Tenggara Regional Hospital. Bali Medical Journal, 9(2), 423–429. https://doi.org/10.15562/bmj.v9i2.1871

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Nurul Qiyaam
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Baiq Leny Nopitasari
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Baiq Leny Nopitasari
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Cyntiya Rahmawati
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Baiq Nurbaety
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Emasiska Ajeng Pratiwi
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