Cost Analysis and Value of Utility for Patients in Haemodialysis with Carbonic Cevelamer Therapy
DOI:
https://doi.org/10.30649/obj.v1i2.12Keywords:
analisis biaya, EQ-5D-%L, nilai utilitas, hemodialisa, sevelamer karbonatAbstract
Sevelamer karbonat merupakan alternatif lain sebagai terapi pengikat fosfat yang
diberikan kepada pasien hemodialisa selain CaCO3. Sevelamer karbonat dapat
menurunkan kadar fosfat, mengurangi kejadian kalsifikasi vaskular dan mortalitas yang
secara langsung berdampak pada perbaikan kualitas hidup pasien hemodialisa, namun
harga sevelamer karbonat lebih mahal dibandingkan dengan CaCO3. Penelitian ini
bertujuan untuk mengetahui gambaran biaya yang diperlukan untuk terapi sevelamer
karbonat dan nilai utilitas pasien hemodialisa yang menggunakan terapi sevelamer
karbonat di RS UGM Yogyakarta.
Penelitian dilakukan secara prospektif selama 8 minggu di RS UGM Yogyakarta
pada bulan Oktober-November 2016. Desain penelitian adalah quasi eksperimental
dengan “pretest posttest design with control group”. Kelompok eksperimental adalah
sevelamer karbonat dan kontrol adalah CaCO3. Pengukuran health related quality of life
(HRQOL) pasien hemodialisa salah satunya dengan mengukur utilitas pasien hemodialisa
dengan kuesioner EQ-5D-5L pada awal (pre) dan akhir (post) penelitian. Analisis biaya
dilihat berdasarkan perspektif rumah sakit dengan menghitung total direct medical cost.
Jumlah total responden dalam penelitian ini adalah 37 pasien yang terdiri atas 16
pasien kelompok eksperimental dan 21 pasien kelompok kontrol. Rata-rata biaya yang
diperlukan pasien hemodialisa dengan sevelamer karbonat untuk menangani kondisi
gangguan mineral dan tulang adalah sebesar Rp 2.999.188,75±167.920,75 per pasien
selama 8 minggu terapi. Nilai utilitas dan skor EQ-5D VAS baseline pasien hemodialisa
yang diberikan sevelamer karbonat adalah masing-masing 0,91±0,13 dan 75,93±9,34, dan
di akhir penelitian (posttes) terdapat perubahan nilai utilitas dan skor EQ-5D VAS sebesar
0,93±0,08 dan 77,44±11,12. Hasil uji statistik menunjukkan bahwa perubahan nilai
utilitas dan skor EQ-5D VAS pasien hemodialisa yang diberikan sevelamer karbonat
antara awal (pre) dan akhir penelitian (posttes) adalah menunjukkan tidak berbeda
bermakna (p>0,05).
References
Anees, M., Hameed, F., Mumtaz, A., Ibrahim, M., dan Saeed Khan, M.N., 2011. Dialysisrelated factors affecting quality of life in patients on hemodialysis. Iranian
Journal of Kidney Diseases, 5: 9–14.
Block, G.A., 2004. Mineral Metabolism, Mortality, and Morbidity in Maintenance
Hemodialysis. Journal of the American Society of Nephrology, 15: 2208–2218.
Chiu, Y.-W., Teitelbaum, I., Misra, M., de Leon, E.M., Adzize, T., dan Mehrotra, R.,
Pill Burden, Adherence, Hyperphosphatemia, and Quality of Life in
Maintenance Dialysis Patients. Clinical Journal of the American Society of
Nephrology, 4: 1089–1096.
Coladonato, J.A., 2005. Control of Hyperphosphatemia among Patients with ESRD.
Journal of the American Society of Nephrology, 16: S107–S114.
Di Iorio, B., Molony, D., Bell, C., Cucciniello, E., Bellizzi, V., Russo, D., dkk., 2013.
Sevelamer Versus Calcium Carbonate in Incident Hemodialysis Patients: Results
of an Open-Label 24-Month Randomized Clinical Trial. American Journal of
Kidney Diseases, 62: 771–778.
Endarti, D., Riewpaiboon, A., Thavorncharoensap, M., Praditsitthikorn, N., Hutubessy,
R., dan Kristina, S.A., 2015. Evaluation of Health-Related Quality of Life among
Patients with Cervical Cancer in Indonesia. Asian Pacific Journal of Cancer
Prevention, 16: 3345–3350.
Faridah, A., Jamaiyah, H., Goh, A., Soraya, A., dan others, 2010. The validation of the
EQ-5D in Malaysian dialysis patients. Med J Malaysia, 65: 114–119.
Fröschl, B., Brunner-Ziegler, S., Hiebinger, C., Wimmer, A., dan Zsifkovits, J., 2009.
Effectiveness and cost-efficiency of phosphate binders in hemodialysis. GMS
health technology assessment, 5: .
Galante, J., Augustovski, F., Colantonio, L., Bardach, A., Caporale, J., Marti, S. G., dkk.,
Estimation and comparison of EQ-5D health states’ utlity weights for
pneumonococcal and human papillomavirus disease in Argentina, Chile, and the
United Kingdom. Value in Health: The Journal of the International Society for
Pharmacoeconomics and Outcomes Research, 14: S60-S64.
Gerogianni, S.K. dan Babatsikou, F.P., 2014. Psychological Aspects in Chronic Renal
Fail. Health science journal, 8: .
Grinfeld, J., Inaba, A., dan Hutchison, A.J., 2010. Update and critical appraisal of
sevelamer in the management of chronic renal failure. Open Access Journal of
Urology, 2: 161–170.
Huybrechts, K.F., Caro, J.J., Wilson, D.A., dan O’Brien, J.A., 2005. Health and Economic
Consequences of Sevelamer Use for Hyperphosphatemia in Patients on
Hemodialysis. Value in Health, 8: 549–561.
Javanbakht, M., Abolhasani, F., Mashayekhi, A., Baradaran, H.R., dan Jahangiri noudeh,
Y., 2012. Health Related Quality of Life in Patients with Type 2 Diabetes Mellitus
in Iran: A National Survey. PLoS ONE, 7: .
Jhita, T., Petrou, S., Gumber, A., Szczepura, A., Raymond, N.T., dan Bellary, S., 2014.
Ethnic differences in health related quality of life for patients with type 2 diabetes.
Health and Quality of Life Outcomes, 12: 83.
Katayama, A., Miyatake, N., Nishi, H., Uzike, K., Sakano, N., Hashimoto, H., dkk., 2014.
Evaluation of physical activity and its relationship to health-related quality of life
in patients on chronic hemodialysis. Environmental Health and Preventive
Medicine, 19: 220–225.
Lahana, E., dan Niakas, D., 2013. Investigating Differences in Health-Related Quality of
Life of Greeks and Albanian Immigrants with the Generic EQ-5D Questionnaire.
BioMed Research International, 2013.
Liem, Y.S., Bosch, J.L., dan Myriam Hunink, M.G., 2008. Preference-Based Quality of
Life of Patients on Renal Replacement Therapy: A Systematic Review and MetaAnalysis. Value in Health, 11: 733–741.
Matsushita, K., Sato, K., Unagami, K., Nitta, K., dan Tago, K., 2014. Effect of Sevelamer
Hydrochloride on the Serum Calcitriol Concentration in Hemodialysis Patients.
International Journal of Clinical Medicine, 05: 1320–1327.
Nadin, C., 2004. Sevelamer as a phosphate binder in adult hemodialysis patients: an
evidence-based review of its therapeutic value. Core evidence, 1: 43–63.
Nurchayati, S., 2010. 'Analisis Faktor-Faktor Yang Berhubungan dengan Kualitas Hidup
Pasien Penyakit Ginjal Kronik yang Menjalani Hemodialisis di Rumah Sakit
Islam Fatimah Cilacap dan Rumah Sakit Umum Banyumas', , Tesis, . Universitas
Indonesia, Jakarta.
Pattanaphesaj, J., 2014. 'Health-Related Quality of Life Measure (EQ-5D-5L) :
Measurement Property Testing and Its Preference-Based Score in Thai
Population', , Doctoral Dissertation, . Mahidol University, Thailand.
Pierce, D., Hossack, S., Poole, L., Robinson, A., Van Heusen, H., Martin, P., dkk., 2011.
The effect of sevelamer carbonate and lanthanum carbonate on the
pharmacokinetics of oral calcitriol. Nephrology Dialysis Transplantation, 26:
–1621.
Price, S.A. dan Wilson, L.M., 2006. Patofisiologi Konsep Klinis Proses-Proses Penyakit,
Edisi 6. ed. Penerbit Buku Kedokteran EGC, Jakarta.
Saffari, M., Pakpour, A.H., Naderi, M.K., Koenig, H.G., Baldacchino, D.R., dan Piper,
C.N., 2013. Spiritual coping, religiosity and quality of life: a study on Muslim
patients undergoing haemodialysis. Nephrology (Carlton, Vic.), 18: 269–275.
Sakthong, P. dan Kasemsup, V., 2012. Health Utility Measured with EQ-5D in Thai
Patients Undergoing Peritoneal Dialysis. Value in Health, 15: S79–S84.
Seica, A., Segall, L., Verzan, C., Văduva, N., Madincea, M., Rusoiu, S., dkk., 2009.
Factors affecting the quality of life of haemodialysis patients from Romania: a
multicentric study. Nephrology Dialysis Transplantation, 24: 626–629.
Shaheen, F.A., Akeel, N.M., Badawi, L.S., dan Souqiyyeh, M.Z., 2004. Efficacy and
safety of sevelamer. Comparison with calcium carbonate in the treatment of
hyperphosphatemia in hemodialysis patients. Saudi medical journal, 25: 785–791.
Wasserfallen, J.-B., Halabi, G., Saudan, P., Perneger, T., Feldman, H.I., Martin, P.-Y.,
dkk., 2004. Quality of life on chronic dialysis: comparison between haemodialysis
and peritoneal dialysis. Nephrology Dialysis Transplantation, 19: 1594–1599.
Yang, F., Griva, K., Lau, T., Vathsala, A., Lee, E., Ng, H.J., dkk., 2015. Health-related
quality of life of Asian patients with end-stage renal disease (ESRD) in Singapore.
Quality of Life Research, 24: 2163–2171.
Zyoud, S.H., Daraghmeh, D.N., Mezyed, D.O., Khdeir, R.L., Sawafta, M.N., Ayaseh,
N.A., dkk., 2016. Factors affecting quality of life in patients on haemodialysis: a
cross-sectional study from Palestine. BMC Nephrology, 17:
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