KAJIAN EFEKTIVITAS DAN BIAYA TERAPI PENGGUNAAN PANTOPRAZOL DAN OMEPRAZOL SEBAGAI TERAPI STRESS RELATED MUCOSAL DISEASE DI INTENSIVE CARE UNIT

LAKSMI NARENDRA P, Prof. Dr. Agung Endro Nugroho, M.Si., Apt; Dr. Tri Murti Andayani, Sp. FRS,Apt

2017 | Tesis | S2 Magister Farmasi Klinik

Pantoprazol dan omeprazol merupakan golongan Proton Pump Inhibitor (PPI) yang banyak digunakan di Indonesia dalam bentuk sediaan injeksi baik sebagai profilaksis maupun sebagai terapi Stress Related Mucosal Disease (SRMD). Tingginya penggunaan PPI sebagai terapi SRMD ini juga mempengaruhi biaya yang diperlukan pasien selama perawatan di Intensive Care Unit (ICU). Penelitian ini bertujuan untuk mengetahui efektivitas dan biaya terapi penggunaan omeprazol dan pantoprazol sebagai terapi Stress Related Mucosal Disease (SRMD). Penelitian ini merupakan penelitian analitik observasional dengan menggunakan rancangan kohort retrospektif, dengan menggunakan data rekam medik pasien ICU selama periode Januari 2015 � Januari 2017. Efektivitas terapi dilihat dari berhentinya overt bleeding atau clinical important bleeding. Analisis biaya dihitung nilai Expected Monetary Value (EMV), Average Cost Effectiveness Ratio (ACER) dan Incremental Cost Effectiveness Ratio (ICER) berdasarkan jumlah biaya yang diperlukan pasien selama perawatan di ICU. Hasil penelitian ini menunjukkan perbedaaan efektivitas penggunaan pantoprazol dan omeprazol sebagai terapi SRMD di ICU. Terapi pantoprazol (92,9%) dinilai lebih efektif dibandingkan omeprazol (66,7%). Terdapat perbedaan nilai EMV untuk omeprazol sebesar Rp. 278.248,84 dan nilai EMV untuk pantoprazol sebesar Rp. 247.242,11. Nilai ACER pada pasien yang menggunakan pantoprazol sebagai terapi SRMD di ICU sebesar Rp. 265.852, nilai ACER pasien yang menggunakan omeprazol sebagai terapi SRMD adalah sebesar Rp. 415.296,77. Terdapat perbedaan efektivitas antara pantoprazol dan omeprazol sebagai terapi SRMD. Biaya untuk terapi SRMD lebih rendah pada terapi pantoprazol dibandingkan omeprazol.

Pantoprazole and omeprazole are Proton Pump Inhibitors (PPI) which are widely used in Indonesia in the form of injection preparation either as prophylaxis or as therapeutic agent for Stress Related Mucosal Disease (SRMD). The high use of PPIs as SRMD therapeutic agent also affects the cost of patients required during treatment at the Intensive Care Unit (ICU). This study aims to determine the effectiveness and cost of therapeutic use of omeprazole and pantoprazole as SRMD therapeutic agents. This study was an observational analytic study using a retrospective cohort design, using medical record data of ICU patients during January 2015 - January 2017. The effectiveness of therapy was observed based on the cessation of overt bleeding or clinical important bleeding. Analysis of effectiveness data used Chi square, and cost analysis was represented by the values of Analisis biaya dihitung nilai Expected Monetary Value (EMV), Average Cost Effectiveness Ratio (ACER) and Incremental Cost Effectiveness Ratio (ICER) based on the amount of costs required by the patient during treatment at the ICU. The results of this study show that there is a difference in the effectiveness of pantoprazole and omeprazole as SRMD therapeutic agent in ICU, pantoprazole therapy (92,9%) is considered more effective than omeprazole (66.7%). There is a difference in the value of EMV in patients taking pantoprazole as SRMD therapeutic agent in ICU was Rp. 247.242,11 and the value of EMV patients using omeprazole as SRMD therapeutic agent was Rp. 278.248,84. There is a difference in the value of ACER in patients taking pantoprazole as SRMD therapeutic agent in ICU was Rp. 265.852 and the value of ACER patients using omeprazole as SRMD therapeutic agent was Rp. 415.296,77. There was a difference in the effectiveness between pantoprazole and omeprazole as SRMD therapy. The cost of pantoprazole utilization also lower than omeprazole.

Kata Kunci : Stress Related Mucosal Disease, Intensive Care Unit, Omeprazol, Pantoprazol