Cost-effectiveness analysis of amlodipine and candesartan in the inpatient setting at Mataram University Hospital in Indonesia, 2021

Authors

  • Nunung Uswatun Hasanah Department of Pharmacy, Faculty of Medicine, University of Mataram, Mataram, Indonesia
  • Ni Made Amelia Ratnata Dewi Department of Pharmacy, Faculty of Medicine, University of Mataram, Mataram, Indonesia https://orcid.org/0000-0003-1168-9395
  • Yoga Dwi Saputra Department of Pharmacy, Faculty of Medicine, University of Mataram, Mataram, Indonesia

DOI:

https://doi.org/10.46542/pe.2024.243.228233

Keywords:

Amlodipine, Candesartan, Cost-effectiveness analysis, Hypertension

Abstract

Background: Hypertension requires ongoing treatment, which could be costly. There are different single-drug therapy options available, such as amlodipine or candesartan, which have varying costs.

Objective: This study aimed to analyse the cost-effectiveness of amlodipine and candesartan in hypertensive patients by determining the Average Cost Effectiveness Ratio (ACER) and Incremental Cost Effectiveness Ratio (ICER) ratios from a hospital perspective.

Method: This study used probability sampling of retrospective data from 2021 for the analysis. All inpatients who were given single therapy with amlodipine of 10 mg or candesartan of 16 mg were included. Direct medical costs were collected, including medicine and room costs, doctor visits, medical procedures, labour and administration. The effectiveness of the therapy was measured by blood pressure reduction from each therapy. ACER and ICER analyses were conducted to determine the most cost-effective therapy.

Result: A total of 18 samples met the inclusion criteria, 14 patients received amlodipine therapy, and four received candesartan therapy. The results showed that the cost-effectiveness of antihypertensive therapy with amlodipine and candesartan, as measured by ACER, was IDR 74,851.15 and IDR 87,809.25, respectively. The ICER value obtained was IDR 362,768.

Conclusion: The results may suggest that amlodipine is more cost-effective than candesartan.

References

Althanoon, Z. A., & Thanoon, I. A. J. (2022). Comparative effects of amlodipine and candesartan on blood pressure and metabolic profile in non-diabetic hypertensive patients. Pharmacognosy Journal, 14(1), 141–147. https://doi.org/10.5530/pj.2022.14.19

AlRuthia, Y., Alotaibi, F., Jamal, A., Sales, I., Alwhaibi, M., Alqahtani, N., AlNajrany, S. M., Almalki, K., Alsaigh, A., & Mansy, W. (2021). Cost effectiveness of ACEIs/ARBs versus amlodipine monotherapies: A single-center retrospective chart review. Healthcare (Basel, Switzerland), 9(7), 798. https://doi.org/10.3390/healthcare9070798

Arshad, V., Samad, Z., Das, J., Almas, A., Rashid, N., Virani, S. S., Bloomfield, G. S., Jafar, T. H., & Ahmed, B. (2021). Prescribing patterns of antihypertensive medications in low- and middle-income countries: A systematic review. Asia-Pacific Journal of Public Health, 33(1), 14–22. https://doi.org/10.1177/1010539520965280

Baroroh, F., Sari, A., & Masruroh, N. (2019). Cost effectiveness analysis of candesartan therapy in comparison to Candesartan-Amlodipine therapy on hypertensive outpatients. Open Access Macedonian Journal of Medical Sciences, 7(22), 3837–3840. https://doi.org/10.3889/oamjms.2019.515

Chan, L., Chen, C. H., Hwang, J. J., Yeh, S. J., Shyu, K. G., Lin, R. T., Li, Y. H., Liu, L. Z., Li, J. Z., Shau, W. Y., & Weng, T. C. (2016). Cost-effectiveness of amlodipine compared with valsartan in preventing stroke and myocardial infarction among hypertensive patients in Taiwan. International journal of general medicine, 9, 175–182. https://doi.org/10.2147/IJGM.S102095

Davari, M., Sorato, M. M., Kebriaeezadeh, A., & Sarrafzadegan, N. (2022). Cost-effectiveness of hypertension therapy based on 2020 International Society of Hypertension guidelines in Ethiopia from a societal perspective. PLoS ONE, 17(8 August). https://doi.org/10.1371/journal.pone.0273439

James, P. A., Oparil, S., Carter, B. L., Cushman, W. C., Dennison-Himmelfarb, C., Handler, J., Lackland, D. T., LeFevre, M. L., MacKenzie, T. D., Ogedegbe, O., Smith, S. C., Svetkey, L. P., Taler, S. J., Townsend, R. R., Wright, J. T., Narva, A. S., & Ortiz, E. (2014). 2014 Evidence-based guideline for the management of high blood pressure in adults: Report from the panel members appointed to the Eighth Joint National Committee (JNC 8). Jama, 311(5), 507–520. https://doi.org/10.1001/jama.2013.284427

Lestari, M. C., Hasina, R., & Dewi, N. M. A. R. (2021). Pola Pemberian Obat Antihipertensi pada Pasien Geriatri di Instalasi Rawat Inap RSUD Provinsi NTB Tahun 2017. Jurnal Pharmascience, 8(1), 23. https://doi.org/10.20527/jps.v8i1.9444

Nalang, A., Citraningtyas, G., & Lolo, W. A. (2018). Nalang, A. (2018). Analisis efektivitas biaya (Cost effectiveness analysis) pengobatan pneumonia menggunakan antibiotik seftriakson dan sefotaksim di RSUP Prof. Dr. R. D. Kandou Manado. Pharmacon, 7(3). https://doi.org/10.35799/pha.7.2018.20599), 321–329.

Ogihara, T., Nakao, K., Fukui, T., Fukiyama, K., Ueshima, K., Oba, K., Sato, T., & Saruta, T. (2008). Effects of candesartan compared with amlodipine in hypertensive patients with high cardiovascular risks: Candesartan antihypertensive survival evaluation in Japan trial. Hypertension, 51(2), 393–398. https://doi.org/10.1161/HYPERTENSIONAHA.107.098475

Perawati, S., Andriani, M., & Utaka, T.. (2021). Analisis efektifitas biaya penggunaan obat hipertensi amlodipin dan candesartan pada pasien Bpjs rawat inap di Rumah Sakit Dr. Bratanata Jambi Tahun 2019. PHARMA XPLORE, 6(2). https://doi.org/10.36805/jpx.v6i2.1941

Perhimpunan Rumah Sakit Seluruh Indonesia. (2020). Rumah sakit di Indonesia. Persi. https://persi.or.id/wp-content/uploads/2020/11/data_statistikrs.htm

Puspitasari, C. E., Widiyastuti, R., Dewi, N. M. A. R., Woro, O. Q. L., & Syamsun, A. (2022). Profile of Drug Related Problems (DRPs) on Hypertension in Outpatients Installation at one of Mataram Government Hospital in 2018. Jurnal Sains Dan Kesehatan, 4(SE-1), 77–87. https://doi.org/10.25026/jsk.v4iSE-1.1692

Rai, M., & Goyal, R. (2018). Pharmacoeconomics in Healthcare. Pharmaceutical Medicine and Translational Clinical Research, 465–472. https://doi.org/10.1016/b978-0-12-802103-3.00034-1

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

Wu, Y., Zhou, Q., Xuan, J., Li, M., Zelt, S., Huang, Y., Yin, H., & Huang, M. (2013). A cost-effectiveness analysis between amlodipine and angiotensin II receptor blockers in stroke and myocardial infarction prevention among hypertension patients in China. Value in health regional issues, 2(1), 75–80. https://doi.org/10.1016/j.vhri.2013.01.005

Downloads

Published

01-05-2024

How to Cite

Hasanah, N. U., Dewi, N. M. A. R., & Saputra, Y. D. (2024). Cost-effectiveness analysis of amlodipine and candesartan in the inpatient setting at Mataram University Hospital in Indonesia, 2021. Pharmacy Education, 24(3), p. 228–233. https://doi.org/10.46542/pe.2024.243.228233