Cost-Effectiveness of Hypertension Treatment with Diabetes Mellitus Complications in Hospitalized Patients at Berkah Pandeglang Regional Hospital Cost-Effectiveness of Hypertension Treatment with Diabetes Mellitus Complications in Hospitalized Patients at Berkah Pandeglang Regional Hospital
Article Sidebar
Main Article Content
Abstract
Hypertension with diabetes mellitus (DM) is a frequent comorbidity that increases clinical complexity and healthcare expenditures. Various antihypertensive and antidiabetic combination therapies are used in hospitalized patients, making pharmacoeconomic evaluation necessary to determine the most cost-effective treatment option. This study aimed to evaluate the cost-effectiveness of hypertension treatment with diabetes mellitus complications in hospitalized patients at Berkah Pandeglang Regional Hospital. This was a non-experimental observational study with a retrospective design using secondary data from medical records and hospital billing data of hospitalized patients diagnosed with hypertension and DM in 2024. Direct medical costs and clinical effectiveness outcomes, including blood pressure control, blood glucose levels, and length of stay (LOS), were analyzed. Cost-effectiveness was assessed using the Average Cost-Effectiveness Ratio (ACER) and Incremental Cost-Effectiveness Ratio (ICER). A total of 9 patients met the inclusion criteria. Of these, 5 patients received captopril, amlodipine, and metformin, while 4 patients received amlodipine, candesartan, bisoprolol, metformin, and glimepiride. The combination therapy of captopril and amlodipine with metformin showed the lowest ACER value (IDR 25,941), indicating the most cost-effective regimen. Another combination consisting of amlodipine, candesartan, and bisoprolol with metformin and glimepiride had a higher ACER value (IDR 82,621). Both regimens were located in quadrant II of the cost-effectiveness plane, representing lower costs with higher effectiveness. The combination of captopril, amlodipine, and metformin was identified as the most cost-effective therapy for hospitalized patients with hypertension and diabetes mellitus complications at Berkah Pandeglang Regional Hospital.
Downloads
Article Details
This work is licensed under a Creative Commons Attribution-ShareAlike 4.0 International License.
Authors who publish in PharmaCine: Journal of Pharmacy, Medical and Health Science agree to the following terms:
- Authors retain copyright and grant the journal right of first publication with the work simultaneously licensed under a Creative Commons Attribution-ShareAlike 4.0 International License that allows others to share the work with an acknowledgment of the work's authorship and initial publication in this journal.
- Authors can enter into separate, additional contractual arrangements for the non-exclusive distribution of the journal's published version of the work (e.g., post it to an institutional repository or publish it in a book), with an acknowledgment of its initial publication in this journal.
- Authors are permitted and encouraged to post their work online (e.g., in institutional repositories or on their website) prior to and during the submission process, as it can lead to productive exchanges, as well as earlier and greater citation of published work (See The Effect of Open Access).
PharmaCine : Journal of Pharmacy, Medical and Health Science by https://jhs.unsika.ac.id/ is licensed under a Creative Commons Attribution-ShareAlike 4.0 International License.
You are free to:
- Share, copy and redistribute the material in any medium or format
- Adapt, remix, transform, and build upon the material for any purpose, even commercially.
- The licensor cannot revoke these freedoms as long as you follow the license terms.
References
Abdus, M., Bhuiyan, S., Wara, U., Chowdhury, K., & Sharker, M. A. (2025). European Journal of Cardiovascular Medicine ( EJCM ) Comorbidity Profile of Hypertension and Diabetes Among Middle-Aged and Elderly Patients in a Clinical Setting. (10), 418–422.
American Diabetes Association Professional Practice Committee. (2024). 10. Cardiovascular Disease and Risk Management: Standards of Care in Diabetes-2024. Diabetes Care, 47(Suppl 1), S179–S218. https://doi.org/10.2337/dc24-S010
Anggraini, D. W., Nurmainah, N., & Rizkifani, S. (2023). Analisis Efektivitas Biaya Antihipertensi Amlodipin Tunggal dan Kombinasi pada Pasien Hipertensi dengan Diabetes Melitus Tipe II Rawat Jalan di Rumah Sakit di Kota Pontianak. Jurnal Pharmascience, 10(2), 329. https://doi.org/10.20527/jps.v10i2.16014
Bang, H., & Zhao, H. (2012). Average cost-effectiveness ratio with censored data. Journal of Biopharmaceutical Statistics, 22(2), 401–415. https://doi.org/10.1080/10543406.2010.544437
Drummond, M. F., Sculpher, M. J., Claxton, K., Stoddart, G. L., & Torrance, G. W. (2015). Methods for the Economic Evaluation of Health Care Programmes (4th ed.). Oxford University Press PL - Oxford.
Dung, L. D., & Long, G. T. (2016). Gender differences in prevalence and associated factors of multi-morbidity among older persons in Vietnam. International Journal on Ageing in Developing Countries, 1(2), 113–132.
Gunes, Y. (2025). A brief approach to hypertension in type 2 diabetes mellitus. Exploration of Endocrine and Metabolic Diseases, 1–13. https://doi.org/10.37349/eemd.2025.101422
Kearney, P. M., Whelton, M., Reynolds, K., Muntner, P., Whelton, P. K., & He, J. (2005). Global burden of hypertension: analysis of worldwide data. The Lancet, 365(9455), 217–223. https://doi.org/10.1016/S0140-6736(05)17741-1
King, J. B., An, J., Bellows, B. K., Cohen, J. B., Commodore-Mensah, Y., Ghazi, L., Langford, A. T., Brook, R. D., & Cardiology, on behalf of the A. H. A. C. on H. C. on C. and S. N. and C. on C. (2026). Single-Pill Combination Therapy for the Management of Hypertension: A Scientific Statement From the American Heart Association. Hypertension, 0(0). https://doi.org/10.1161/HYP.0000000000000258
Kiss, N., Hiesmayr, M., Sulz, I., Bauer, P., Heinze, G., Mouhieddine, M., Schuh, C., Tarantino, S., & Simon, J. (2021). Predicting Hospital Length of Stay at Admission Using Global and Country-Specific Competing Risk Analysis of Structural, Patient, and Nutrition-Related Data from nutritionDay 2007-2015. Nutrients, 13(11). https://doi.org/10.3390/nu13114111
Mohan, R., Shantini, D., Jawahir, S., Manual, A., Abdul Mutalib, N. E., Mohd Noh, S. N., Ab Rahim, I., Ab Hamid, J., & Amer Nordin, A. (2025). Gender differences in health-seeking behaviour: insights from the National Health and Morbidity Survey 2019. BMC Health Services Research, 25(1), 900. https://doi.org/10.1186/s12913-025-13020-0
Muir, A. J., Sanders, L. L., Wilkinson, W. E., & Schmader, K. (2001). Reducing medication regimen complexity: a controlled trial. Journal of General Internal Medicine, 16(2), 77–82. https://doi.org/10.1046/j.1525-1497.2001.016002077.x
Murru, V., Belfiori, E., Sestu, A., Casanova, A., Serra, C., & Scuteri, A. (2025). Patterns of comorbidities differentially impact on in-hospital outcomes in heart failure patients. BMC Geriatrics, 25(1), 371. https://doi.org/10.1186/s12877-025-06002-8
Neumann, P. J., Cohen, J. T., & Weinstein, M. C. (2026). Updating Cost-Effectiveness — The Curious Resilience of the $50,000-per-QALY Threshold. New England Journal of Medicine, 371(9), 796–797. https://doi.org/10.1056/NEJMp1405158
Putri, A. S., & Dyahariesti, N. (2021). Analisis Efektivitas Biaya Kombinasi Obat Antihipertensi Pada Pasien Rawat Inap Di RS PKU Muhammadiyah Yogyakarta Tahun 2020. Indonesian Journal of Pharmacy and Natural Product, 4(2), 95–106. https://doi.org/10.35473/ijpnp.v4i2.1296
Tonin, F. S., Aznar-Lou, I., Pontinha, V. M., Pontarolo, R., & Fernandez-Llimos, F. (2021). Principles of pharmacoeconomic analysis: The case of pharmacist-led interventions. Pharmacy Practice, 19(1), 1–10. https://doi.org/10.18549/PharmPract.2021.1.2302
Unger, T., Borghi, C., Charchar, F., Khan, N. A., Poulter, N. R., Prabhakaran, D., Ramirez, A., Schlaich, M., Stergiou, G. S., Tomaszewski, M., Wainford, R. D., Williams, B., & Schutte, A. E. (2020). 2020 International Society of Hypertension Global Hypertension Practice Guidelines. Hypertension, 75(6), 1334–1357. https://doi.org/10.1161/HYPERTENSIONAHA.120.15026
Wang, W., Wan, Q., Wang, S., Ning, G., Bi, Y., Liu, L., Liu, Y., Liu, Y., Li, X., Li, T., Wu, X., Wu, S., Sha, Y., Zhang, Y., Chen, R., Zheng, H., Zhao, D., Hu, L., Duan, P., … Pan, H. (2025). Management Guidelines for Diabetic Patients With Hypertension. Journal of Diabetes, 17(6), e70093. https://doi.org/10.1111/1753-0407.70093
World Health Organization. (2025). Hypertension.
Zheng, W.-X., Liao, P., Luo, L.-L., Gu, J., Du, L., & Tian, Y.-Z. (2025). Risk factors for comorbid hypertension in elderly patients with type 2 diabetes. American Journal of Translational Research, 17(8), 6453–6461. https://doi.org/10.62347/UCOV1190