COST EFECTIVENESS ANALYSIS TERAPI ANTIDIABETES ORAL KOMBINASI PASIEN GEN Z RAWAT JALAN DI RS DEWI SRI

Abstract

The prevalence of type 2 diabetes mellitus among younger age groups, including Generation Z (born 1997–2012), has increased significantly. Combination therapy using oral antidiabetic drugs is a preferred approach to optimally control blood glucose levels. However, the clinical effectiveness and cost burden of various drug combinations need to be analyzed, especially considering the country's limited healthcare budget. This study aims to assess the cost-effectiveness of different oral antidiabetic combination therapies used by outpatient Generation Z patients at Dewi Sri Karawang Hospital. This research is a descriptive-analytic study with a cross-sectional approach. Data were obtained from the medical records of Generation Z patients (aged 12–27 years) undergoing oral antidiabetic combination therapy at Dewi Sri Karawang Hospital. The cost analysis was conducted from the hospital's perspective by calculating direct medical costs. Effectiveness was measured based on the reduction in random blood glucose levels. The Average Cost-Effectiveness Ratio (ACER) and Incremental Cost-Effectiveness Ratio (ICER) were used to compare the effectiveness of the therapies. The combination of Glibenclamide 5 mg + Metformin 500 mg was found to be more cost-effective, with a result of IDR 4,614/mg/dL for outpatient Generation Z patients at Dewi Sri Karawang Hospital, compared to the Acarbose 50 mg + Metformin 500 mg combination, which had an ACER value of IDR 8,744/mg/dL. Based on the ICER calculation, switching from Acarbose 50 mg + Metformin 500 mg to Glimepiride 2 mg + Metformin 500 mg, in the event of a stock-out, would require an additional cost of IDR 61,288/mg/dL. These findings may serve as a consideration for making efficient and affordable therapy decisions.