Nama : Badzlina Azyyati Maizan

NIM : 201710410311253

Kelas : Farmasi A

Dosen : Elva Asmiati M.Clin.Pharm.,Apt

1. Perhitungan Analisis CEA

No. Langkah Jawaban

Tentukan tujuan Untuk membandingkan cost-effectiveness dari 2
agent antiemetic yaitu ondansetron dan
prochlorperazine untuk pencegahan
1. Postoperative Nausea and Vomitting (POVN)
pada pasien yang menjalani prosedur
penggantian pinggul atau lutut.

Buat daftar cara untuk Membandingkan :

mencapai tujuan tersebut  Ondansetron
( obat A )
2.
 Prochlorperazine
( obat B )

Identifikasi tingkat efektivitas Hasil studi literature menunjukkan :

 Efektivitas pengobatan A (POVN free) :
18,9%
3.
 Efektivitas pengobatan B (POVN free) :
43,9%

Identifikasi dan hitung biaya Biaya yang teridentifikasi dan diukur adalah
pengobatan biaya medikasi, biaya kunjungan ke unit gawat
darurat, biaya rawat inap :
 Biaya rerata pengobatan A :
$51,98/pasien
 Biaya rerata pengobatan B :
4. $13,99/pasien
 Sudah termasuk biaya obat: ondansetron
(Zofran) 4 mg single-dose vial = $26,71;
prochlorperazine 10 mg single-dose vial
(generic, Watson Pharmaceutical) =
$9,56
 Hitung dan lakukan a. Hitung ratio efektivitas biaya (REB)
interpretasi efektivitas biaya setiap pengobatan dengan rumus:
dari pilihan pengobatan Biaya/efektivitas
 REB Pengobatan A =
$51,98/0,189 = $275,03
 REB Pengobatan B =
$13,99/0,439 = $31,87
5.
b. Tentukan posisi alternatif pengobatan
dalam tabel atau Diagram Efektivitas
biaya

Biaya Biaya
Efektitivitas Biaya
lebih lebih
biaya sama
rendah tinggi
Efektivitas Interpretasi A Antara pengobatan B dan A harus dipilih
lebih 6. - - terhadap pengobatan B, karen efektivitasnya lebih tinggi
rendah B dengan biaya yang lebih rendah.
Efektivitas
-
Kesimpulan - - Prochlorperazine memilih efektivitas dalam
sama
B mencegah PONV lebih tinggi dan memiliki
Efektivitas7. biaya (cost-effectiveness) yang lebih rendah
terhadap - -
lebih tinggi daripada Ondansetron.
A

2. Critical Appraisal pada jurnal “Cost-Effectiveness Analysis of Ondansetron and

Prochlorperazine for the Prevention of Postoperative Nausea and Vomiting”

CHEERS Checklist

Items to include when reporting economic evaluations of health interventions

Section Item Recommendation Reported on

No page No/line
No
Title and Abstract
Title 1 Identify the study as an economic evaluation or use more Hal 317
specific terms such as “cost-effectiveness analysis”, and baris 1-2
describe the interventions compared.

Keterangan : Terdapat di judul tentang pembiayaan

Abstract 2 Provide a structured summary of objectives, perspective, Hal 317
setting, methods (including study design and inputs), results Baris 1-26
(including base case and uncertainty analyses), and
conclusions.

Keterangan : ringkasan dari tujuan, perpesktif, metode, hasil

dan kesimpulan terdapat di abstrak.

Introduction
Background and 3 Provide an explicit statement of the broader context for the Hal 317
objectives study. Present the study question and its relevance for Baris 2-19
health policy or practice decisions.
 Keterangan : terdapat kebijakan kesehatan atau keputusan
praktik pada pedoman terapi Apoteker Sistem Kesehatan
Masyarakat Amerika
Methods
Target population 4 Describe characteristics of the base case population and Hal 318
and subgroups subgroups analysed, including why they were chosen.

Keterangan : dalam jurnal ini telah dijelaskan karakteristik

subjek coba tetapi tidak terdapat penjelasan tentang
mengapa subjek tersebut dipilih
Setting and location 5 State relevant aspects of the system(s) in which the Page 1-2
decision(s) need(s) to be made. baris 1-2

Keterangan : penelitian ini dilakukan untuk mengevaluasi

penelitian sebelumnya.

Study perspective 6 Describe the perspective of the study and relate this to the Hal. 318
costs being evaluated. Baris 2-3
 Keterangan : Biaya perspektif telah dijelaskan dengan jelas
pada bagian statical analisis

Describe the interventions or strategies being compared and Hal 320. Baris
Comparators 7 state why they were chosen. 1-6

Keterangan : penelitian ini memiliki strategi yg dominan

untuk pilih.
Time horizon 8 State the time horizon(s) over which costs and Hal
consequences are being evaluated and say why appropriate. 317,Paragraph
5,baris 1
Hal
318,Paragraph
1 baris 1

Keterangan : dalam studi klinis asli data diambil selama

satu hayun yakni mulai tabhun 1995-1996
Discount rate Report the choice of discount rate(s) used for costs and Hal 319
 9 outcomes and say why appropriate. Baris 17-24

Keterangan : biaya ondansetron berkurang hingga 50%, dan

rasio c/e direkontruksi untuk setiap hasil.
Choice of health 10 Describe what outcomes were used as the measure(s) of Hal 319.
outcomes benefit in the evaluation and their relevance for the type of Bagian result
analysis performed. baris ke 29-34

Keterangan : dalam rasio C/E memiliki hasil yg berbeda

Measurement of 11a Single study-based estimates: Describe fully the design Halaman 2,
effectiveness features of the single effectiveness study and why the single baris 21-39
study was a sufficient source of clinical effectiveness data.

Keterangan: menggunakan model analisis efektivitas biaya

yang diterapkan pada data yang diturunkan dari studi klinis
sebelumnya yang dilakukan pada 1995 dan 1996.
 11b Synthesis-based estimates: Describe fully the methods used
for identification of included studies and synthesis of none
clinical effectiveness data.
Measurement and 12 If applicable, describe the population and methods used to Halaman 1,
valuation of elicit preferences for outcomes. paragraph ke
preference based 2 dari abstarct
outcomes

Halaman 3,
paragraph 1-2

Keterangan : Population melibatkan 78 pasien dewasa

dengan beberapa karakteristik dan data-data penelitian
dilihat dari studi klinis sebelumnya. Dengan hasil perbedaan
biaya dari ondansetron dan proklorperazin.
Estimating 13a Single study-based economic evaluation: Describe
resources and costs approaches used to estimate resource use associated with Page 319 1st
the alternative interventions. Describe primary or secondary paragraph,
research methods for valuing each resource item in terms of baris 4-5
its unit cost. Describe any adjustments made to approximate
to opportunity costs.
 Keterangan : Pada artikel jurnal ini, peneliti menggunakan
single study-based economic evaluation karena estimasi
biaya langsung dilakukan oleh peneliti.
13b Model-based economic evaluation: Describe approaches
and data sources used to estimate resource use associated none
with model health states. Describe primary or secondary
research methods for valuing each resource item in terms of
its unit cost. Describe any adjustments made to approximate
to opportunity costs.
14 Report the dates of the estimated resource quantities and Page 319, 2nd
Currency, price unit costs. Describe methods for adjusting estimated unit paragraph,
date, and costs to the year of reported costs if necessary. Describe baris 3-4
conversion methods for converting costs into a common currency base
and the exchange rate.

Keterangan : Peneliti memperkirakan total biaya yang

dikeluarkan per pasien dengan mengurangi sekitar biaya
ondansteron sebesar 50%.
Choice of model 15 Describe and give reasons for the specific type of decision- None
analytical model used. Providing a figure to show model
structure is strongly recommended.
Assumptions 16 Describe all structural or other assumptions underpinning None
the decision-analytical model.
Analytical methods 17 Hal. 317-318
Describe all analytical methods supporting the evaluation. Baris 1-12
This could include methods for dealing with skewed,
missing, or censored data; extrapolation methods; methods
for pooling data; approaches to validate or make
adjustments (such as half cycle corrections) to a model; and
methods for handling population heterogeneity and
uncertainty.

Keterangan : Telah dijelaskan metodenya dengan jelas.

Result
Study parameters 18 Report the values, ranges, references, and, if used, Hal. 319
probability distributions for all parameters. Report reasons Baris 4-5
or sources for distributions used to represent uncertainty
where appropriate. Providing a table to show the input
values is strongly recommended.
 Keterangan : dari table telah dijelaskan nilai input.
Incremental costs 19 For each intervention, report mean values for the main Hal 319
and outcomes categories of estimated costs and outcomes of interest, as Bagian result
well as mean differences between the comparator groups. If baris ke 3-7
applicable, report incremental cost-effectiveness ratios.

Keterangan : perbedaan rata-rata anatara kelompok

pembanding.
Characterizing 20a Single study-based economic evaluation: Describe the Hal
uncertainty effects of sampling uncertainty for the estimated 320
incremental cost and incremental effectiveness parameters, paragraf 4
together with the impact of methodological assumptions
(such as discount rate, study perspective).

Keterangan : Sudah dijelaskan pada paragraf tersebut

 20b Model-based economic evaluation: Describe the effects on None
the results of uncertainty for all input parameters, and
uncertainty related to the structure of the model and
assumptions.
Characterizing If applicable, report differences in costs, outcomes, or cost- Hal 320
heterogeneity 21 effectiveness that can be explained by variations between Bagian
subgroups of patients with different baseline characteristics result baris
or other observed variability in effects that are not reducible ke 43-48
by more information.

Keterangan : terdapat perbedaan dalam biaya atau

efektivitas biaya yg dapat dijelaskan pada perbedaan obat
ini.
Discussion
Study findings, Summarise key study findings and describe how they Hal 320
limitations, 22 support the conclusions reached. Discuss limitations and Study
generalizability, and the findings:
current knowledge generalisability of the findings and how the findings fit with Baris 21-24
current knowledge. Limitations:
baris 47-55

Keterangan : penggunaan obat prochlorperazine lebih

hemat biaya dan lebih efektif dibandingkan ondansetron.
Other
Source of funding Describe how the study was funded and the role of the Halaman
23 funder in the identification, design, conduct, and reporting 321 baris 1
of the analysis. Describe other non-monetary sources of
support.
 Keterangan : tidak ada dana dari luar yang mendukung
studi ini.
24 Describe any potential for conflict of interest of study Halaman
Conflicts of interest contributors in accordance with journal policy. In the 321 baris 1-
absence of a journal policy, we recommend authors comply 9
with International Committee of Medical Journal Editors
recommendations.

Keterangan : tidak ada potensi bias atau konflik

kepentingan terkait hal ini.

3. A. Prochlorperazine memilih efektivitas dalam mencegah PONV lebih tinggi dan

memiliki biaya (cost-effectiveness) yang lebih rendah daripada Ondansetron.

B. Sebelum menerapkan jurnal tersebut, ada beberapa faktor yang harus diperhatikan,
antara lain :
 Jenis keluhan pasien dan obat yang diberikan
 Farmakoekonomi
 Dipilih yang lebih cocok dengan kondisi pasien
 Efektivitas obat berdasarkan penelitian yang telah dilakukan