COST-EFFECTIVENESS ANALYSIS OF PHARMACOTHERAPY FOR HEMATEMESIS-MELENA TREATMENT IN HOSPITALIZED PATIENT WITH HEPATIC CIRRHOSIS

Main Authors: Queljoe, Doddy de , Lorensia, Amelia , Widharta, Liana, Widjaja, Sugiarto
Format: Article PeerReviewed application/pdf
Terbitan: The Prodia Education and Research Institute , 2013
Subjects:
Online Access: http://repository.ubaya.ac.id/23900/2/10_abstrak_2013.pdf
http://repository.ubaya.ac.id/23900/3/10A.pdf
http://repository.ubaya.ac.id/23900/
Daftar Isi:
  • BACKGROUND: Acute variceal haemorrhage is a complication of cirrhosis, which could have life threatening impact. It is a pharmacist duty to ensure therapeutic and pharmaceutical care which is not only safe and effective for patients but has also a cost-effective property which purpose is the improvement of patient’s quality of life. Therefore, pharmacoeconomic evaluation specifically CEA (cost-effectiveness analysis) which compare cost and consequences of therapy is needed. This study was aimed to evaluate therapeutic cost-effectiveness of hematemesis-melena treatment in hepatic cirrhosis patients. METHODS: A total of 42 patients receiving vitamin K-only parenterally and combination of vitamin K+transamin parenterally were studied retrospectively from patient’s medical record in 2 years, and analyzed with cost-effectiveness grid and ACER (average cost-effectiveness ratio) based on Child-Turcotte-Pugh Score. RESULTS: Cost-effectiveness grid showed dominant for vitamin K-only in patient with Child-Turcotte-Pugh Score A. ACER analysis showed lower score for vitamin K-only in all patient included Child-Turcotte Pugh Score classification. There were no significant difference for duration of cessation of bleeding treatment in patients with vitamin K-only compare to vitamin K+transamin in patients with Child-Turcotte Pugh Score A and B, while there was significant difference in patients with Child-Turcotte Pugh Score C. CONCLUSION: Vitamin K-only appear to be more cost-effective compare to vitamin K+transamin in all patients. The use of vitamin K-only has greater benefit than the combination of vitamin K with transamin in all patient and Child-Turcotte-Pugh score classification, and should be considered as a primary therapy. Thus, transamin addition as an alternative therapy for hepatic cirrhosis patient with hematemesis-melena should be reconsidered.