Analisis Farmakoekonomi (Cost Effectiveness Analysis) Penggunaan Terapi Infus Imunoglobulin Intravena (IVIG) Pada Kasus Coronary Virus Disease (Covid-19)

https://doi.org/10.22146/farmaseutik.v18i1.71903

Issaura Issaura(1*), Novianti Fatli Azizah(2), Renny Nurul Faizah(3), Ika Putri Jami'atusholihah(4), Shafinaz Nabila Rahmania(5)

(1) Rumah Sakit Umum Daerah Sidoarjo
(2) Rumah Sakit Umum Daerah Sidoarjo
(3) Rumah Sakit Umum Daerah Sidoarjo
(4) Rumah Sakit Umum Daerah Sidoarjo
(5) Rumah Sakit Umum Daerah Sidoarjo
(*) Corresponding Author

Abstract


Imunoglobulin Intravena (IV IG) merupakan produk derivatif plasma pendonor yang dapat memberikan proteksi imun secara pasif terhadap berbagai macam patogen. Pada infeksi Covid-19 yang berat, pemberian terapi infus IV IG dapat mengurangi respon inflamasi, antibodi autoreaktif yang mengikat sitokine dan domain variabel antibodi lain (antibodi anti-idiotipik). Selain itu, kehadiran dimer IgG pada IV IG dapat memblokir pengaktifan FcγR pada sel efektor imun. Tujuan untuk menganalisis Average Cost Effectiveness Ratio (ACER) dan Length of Stay (LOS) penggunaan terapi IV IG sebagai penilaian terhadap urgensitas pemberian terapi IV IG pada pasien COVID-19. Penelitian ditinjau dari perspektif rumah sakit sebagai penyedia layanan kesehatan, menggunakan Total Medical Cost dengan efektifitas LOS pasien. Disajikan dengan analisis deskriptif dan analisa farmakoekonomi efektifitas biaya yang dikerjakan secara retrospektif, pada periode waktu 3 bulan (Juni- Agustus 2020) di Instalasi Rawat Inap Intensive Care Unit (ICU) Isolasi Mawar Merah Putih RSUD Kabupaten Sidoarjo. Didapatkan jumlah sampel yang masuk kriteria inklusi 38 pasien. Kelompok pasien tanpa pemberian IV IG (25 pasien) lebih cost effective dibanding kelompok dengan pemberian IV IG, yaitu lebih menghemat Rp. 2.510.741 dengan LOS ICU 11 hari dibanding IV IG merk Gamaras® (4 pasien), dan lebih menghemat Rp 3.702.561 dengan LOS ICU 6 hari dibanding IV IG merk Intratect® (9 pasein). Dengan uji statistik tanpa pemberian IVIG dengan IVIG merk Gamaras® dan Intratect® menunjukkan LOS tidak bermakna (sig>0,05) dan ACER yang berbeda bermakna (sig<0,05), dengan peringkat efektifitas Tanpa pemberian IV IG, IV IG merk Gamaras® dan IV IG Intratect®

Keywords


Analisis Efektivitas Biaya; CEA; ACER; IVIG; Covid-19

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References

Blackford, M.G., Glover, M.L., and Reed, M.D., 2016. Lower respiratory tract infection. In: Dipiro, J.T., Talbert R.L., Yee, G.C., Matzke, G.R., Wells, B.G., and Posey,L.M., (Eds.). Pharmacotherapy a Pathophysiologic Approach, Ed. 7th, America: The Mc Graw-Hill, pp. 4733-88.

Cao, W., Liu, X., Bai, T., Fan, H., Hong, K., Song, H., Han, Y., Lin, L., Ruan, L., and Li, T., 2020. High-Dose Intravenous Immunoglobulin as a Therapeutic Option for Deteriorating Patients With Coronavirus Disease 2019. Open Forum Infect Disease, pp.1-6.

Centers for Disease Control and Prevention (CDC). 2020. Coronavirus Disease 2019 (COVID-19):OlderAdults.Diaksesdarihttps://www.cdc.gov/coronavirus/2019- ncov/need-extra-precautions/older-adults.html, pada tanggal 15 November2020.

Fang, L., Karakiulakis, G., and Roth, M., 2020. Are patients with hypertension and diabetes mellitus at increased risk for COVID-19 infection?.The Lancet, Vol. 18. p. 21.

Griffith, D.M., Sharma, G., Holliday, C.S., Enyia, O.K., Valliere, M., Semlow, A.R., Stewart, E.C., and Blumenthal, R.S., 2020. Man and COVID-19: A Biopsychosocial Approarch to Understanding Sex Differences in Mortality and Recommendations for Practice and Policy Interventions. Prev Chronic Dis., Vol. 17, No. 63, pp. 1-9

Li, G., Fan, Y., Lai, Y., Han, T., Li, Z., Zhou, P., Pan, P., Wang, W., Hu, D., Liu,X.,Zhang,Q.,andWu,J., 2020.CoronavirusInfectionsandImmuneResponses.J. Med Virol., pp. 1-9.

Lin, L., Lu, L., Cao, W., Li, T., 2020. Hypothesis for potential pathogenesis of SARSCoV-2 infectiona review of immune changes in patients with viral pneumonia. Emerg Microbes Infect, 2020;9:727-32.

Liu, Z., Bing, X., and Zhi, X.Z., 2020. The Epidemiological Characteristics of an Outbreaks of 2019 Novel Coronavirus Disease (COVID-19) in China. J. Epidemiol Chin., Vol. 41 No. 2, pp. 145-51.

Naaraayan, A., Nimkar, A., Hasan, A., Pant, S., Durdevic, M., Elenius, H., Suarez, C.N., and Jesmajian, S. 2020. Analysis of Male Sex as a Risk Factor in Older Adult with Coronavirus Disease 2019: A Retrospective Cohort Study From the New York City Metropolitan Region. Cureus., Vol. 12, No. 8, pp. 1-13.

Nasiri, M.J., Haddadi, S., Tahvildari, A., Farsi, Y., Arbabi, M., Hasanzadeh, S., Jamshidi, P., Murthi, M., and Mirsaeidi, M., 2020. Covid-19 Clinical Characteristic, and SexSpecific Risk of Mortality: Systemic Review and Meta-Analysis. Front. Med., Vol. 7, No. 459, pp. 1-10.

Nguyen, A.A., Habiballah, S.B., Platt, C.D., Geha, R.S., Chou, J.S., and McDonald,D.R., 2020. Immunoglobulins In The Treatment of COVID-19 Infection: Proceed With Caution. Clin. Immunol., Vol. 216, pp. 1-4.

PDPI, PERKI, PAPDI, PERDATIN, IDAI., 2020. Pedoman Tatalaksana Covid-19, Edisi 2, ISBN: 978-623-92964-8-3, Jakarta.

Shao, Z., Feng, Y., Zhong, L., 2020. Clinical efficacy of intravenous immunoglobulin therapy in critical patients with COVID-19: A multicenter retrospective cohort study. medRxiv. 2020;Preprint. Available at: https://www.medrxiv.org/content/10.1101/2020.04.11.20061739v2

Stockman, L.J., Bellamy, R., and Gaul, P., 2006. SARS: Systematic Review of Treatment Effects.PLoS Med., Vol. 3 No. 9, pp. 1525-31.

Zhou, Y., Yang, Q., Chi, J., Dong, B., Wenshan., Shen, L., and, Wang, Y. 2020. Comorbidities and The Risk of Severe or Fatal Outcomes Associated with Coronavirus Disease 2019: A Systematic Review and Meta-Analysis.International J. of Infect Dis. Vol. 99, pp. 47-56.



DOI: https://doi.org/10.22146/farmaseutik.v18i1.71903

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