Profile Evaluation of Medication, Cost Comparison, and Clinical Outcome of Human and Analog Insulin Treatment to Type-2 Diabetes Mellitus Outpatient at Medistra Hospital Year 2012-2013

Elisabeth Ninung Yuliarti; Yusi Anggriani; Dian Ratih Laksmitawati; Prasasta Sutedjo

doi:10.33533/jpm.v14i2.2007

Authors

Elisabeth Ninung Yuliarti Universitas Pancasila
Yusi Anggriani
Dian Ratih Laksmitawati
Prasasta Sutedjo

DOI:

https://doi.org/10.33533/jpm.v14i2.2007

Keywords:

Insulin, Diabetes Mellitus, Human Insulin

Abstract

The data collection was conducted retrospectively, taking samples of 121 outpatients, of which 83 outpatients were evaluated for their clinical outcome. The medication profile data were collected from the medicine administration at the Hospital Pharmacy Installation. The clinical outcome data, such as fasting plasma glucose (FPG), two-hour postprandial plasma glucose (2HPP), and Hemoglobin A1c (HbA1c), were garnered from the patients’ medical records. The cost data were collected from the outpatients’ payment receipts provided by the Hospital’s Financial Department. Kolmogorov Smirnov normality test was applied in this research. The research result suggests that after Mann Whitney Test, the human and analogue insulin were not significantly different seen from the clinical outcome result showing FPG (p=0.676), 2HPP (p=0.175), HbA1c (p=0.0445) and from the cost result (p=0.795). Furthermore, the research also shows that the average cost of 30-day medication of single human insulin was Rp3,190,997.43, while the one of analogue insulin was Rp3,188,832.35. In conclusion, the research finds out that if seen from the cost (p=0.795), the human and the analogue insulin were not significantly different.

References

[1] Ganong W. Buku Ajar Fisiologi Kedokteran. 11th ed. Jakarta: Buku Kedokteran EGC; 2013.

[2] Soelistijo Soebagijo A NHE. Konsensus Pengelolaan dan Pencegahan Diabetes Mellitus Tipe 2 di Indonesia 2015. PB Perkeni; 2015.

[3] Sanlioglu AD, Altunbas HA, Balci MK, Griffith TS SS. Clinical utility of insulin and insulin analogues. 2013; April:67–78.

[4] Pusdatin Kementrian Kesehatan. Infodatin Diabetes Mellitus. 2014.

[5] Organization WHO. Global Report on DM [Internet]. 2016. Available from: www.un.org.au

[6] Ozougwu J C, Oimba KC, Belomwu CD UC. The Pathogenesis and Pathophysiology of Type-1 and Type-2 Diabetes Mellitus. Acad J. 2013; 4:46–57.

[7] Pe M, Boltana A, Insa R, Soler J ME. Comparison of Human Insulin and Insulin Analogues on Hypoglycemia and Metabolic Variability in Type-1 Diabetes Using Standardized Measurement (HYPO Score and Lability Index). Acta Diabetol. 2013;50(529–35).

[8] PERKENI. Konsensus Pencegahan dan Pengelolaan Diabetes Mellitus Tipe 2 di Indonesia. Jakarta; 2015. 6–10, 14–51 p.

[9] Wu Yan Ling, Yan Ping, Ding, Yoshimata Tanaka WZ. Risk Factors Contributing to Type-2 Diabetes and Recent in Treatment and Prevention. J Med Sci. 2014; 11: 1185–200.

[10] PERKENI. Pengelolaan dan pencegahan diabetes melitus tipe 2 di Indonesia 2015. 2015.

[11] Badan POM RI. Insulin. http://pionas.pom.go.id. 2015. p. Bab VI-Sistem Endokrin.

[12] Tibaldi J. Evolution of Insulin: From Human to Analogue. Am J Med. 2014;127(10): S2.

[13] Miriam TE. Why Are There No Generic Insulins? Medscape Medical News [Internet]. 2015; Available from www.medscape.com

[14] Lepore M, Pampanelli S, Fanelli C, Porcellati F, Bartocci L, Vincentzo A Di et al. Pharmacokinetics and Pharmacodynamics of Subcutaneous Injection of Long-Acting Human Insulin Analogue Glargine, NPH Insulin and Ultralente Human Insulin and Continous Subcutaneous Infusion of Insulin Lispro. 2000;49.

[15] Lipska L Kasia, Hirch Irlb RCM. Human Insulin for Type-2 Diabetes: An Effective, Less-Expensive Option. Am Med Assoc. 2017; 23–4.

[16] Hemkens LG, Grouven U, Bender R, Gunster C, Gutschmidt S SGW et al. Risk of Malignancies in Patients with Diabetes Treated with Human Insulin or Insulin Analogues: Cohort Study, Diabetologia. 2009;52(9) (1732–44).

[17] Wu JW, Zoulay L, Majdan A, Boivin JF PMS. Long-Term Use of Long-Acting Insulin Analogues and Breast Incidence in Women with Type-2 Diabetes. J Clin Oncol. 2017.

[18] Till S. Cancer Incidence Among Those Initiating Insulin Therapy with Glargine Versus Human NPH Insulin. 2013;36(3517–25).

[19] Guillermo et. al. Insulin Analogue Versus Human Insulin in the Treatment of Patients with Diabetic Ketoacidosis. NCBI. 2009;1164–9.

[20] Holden S CC. Do the Benefits of Analogue Insulins Justify Their Cost? Future Med. 2012; 2(173–5).

[21] Huo Jing MD. The Fair Price of Analogue Insulin When Compared Against Human Insulin: A Systematic Review of Published Cost-Effectiveness Studies and Mathematic Derivation of a Value-Based Formula. 2017.

[22] Kompas. Pengobatan Diabetes Habiskan 33 Persen Biaya Kesehatan dari BPJS. Kompas Magazine. 2016.

[23] G A. The Road to Free Insulin Guyana Case Study. Heal action Int Ovetoom. 2017.

[24] Veronica WJ. Insulin Market Profile 2016. Department for Global Health and Development Boston University; 2016. 42 p.

[25] American DA. Diagnosis and Classification of Diabetes Mellitus. Diabetes Care. 2010; 27:55.

[26] Putri Nurlaili MI. Hubungan Empat Pilar Pengendalian BM Tipe 2 dengan Rerata Kadar Gula Darah. Berk Epidemiol. 2013;1(2):234–43.

[27] Siebenhofer A. Short-Acting Insulin Analogueuages Versus Regular Human Insulin in Patients with Diabetes Mellitus. NCBI. 2004;1–3.

[28] PERKENI. Petunjuk Praktis Terapi Insulin Pada Pasien Diabetes Mellitus. Jakarta; 2009. 7–8 p.

[29] Huo J. Alternative Funding Sources to Improve Insulin Access: A Briefing Document for Low and Middle-Income Countries. Heal Action Int. 2017;(September):3–8.

[30] Vannapruegs T, Hospital MT, Khunsri S. Thailand Case Study. Heal Action Int Overtoom [Internet]. 2017;60(20):412–4523. Available from: www.haiweb.org

[31] Abdraimova A. Aida Zurdinova Chief Pharmacologist Ministry of Health Kyryzstan Case Study. Heal Action Int Overtoom [Internet]. 2017;60(20):412–4523. Available from: www.haiweb.org

[32] Alarcon G. The Road to Free Insulin: Ecuador Case Study. Heal Action Int Overtoom [Internet]. 2017; 60(20):412–4523. Available from: www.haiweb.org

[33] Kementrian Kesehatan Republik Indonesia. Pedoman Penerapan Kajian Farmakoekonomi. 2013. 14 p.

[34] Setiawan N. Penentuan Ukuran Sampel Memakai Rumus Slovin dan Tabel Krejcie Morgan: Telaah Konsep dan Aplikasinya. 2007.

[35] Yosmar R, Almasdy D, Rahma F. Survei Risiko Penyakit Diabetes Melitus terhadap Kesehatan Masyarakat Kota Padang. J Sains Farm Dan Klin. 2018;5(Agustus 2018):134–41.

[36] Yuhelma, Hasneli I Y, Annis N F. Identifikasi dan Analisis Komplikasi Makrovaskuler dan Mikrovaskuler pada Pasien Diabetes Mellitus. J Online Mhs. 2015; 2(1):569–79.

[37] Santosa A, Trijayanto, Aji P, Endiyanto. Hubungan Riwayat Garis Keturunan dengan Usia Terdiagnosis Diabetes Melitus Tipe II. ISSN. 2017;1–6.

[38] Kementerian Kesehatan Republik Indonesia. Riset Kesehatan Dasar 2018.

[39] Suri MH, Haddani H, Sinulingga S, Studi P, Dokter P, Kedokteran F, et al. Hubungan Karakteristik, Hiperglikemi , dan Kerusakan Saraf Pasien Neuropati Diabetik di RSMH Palembang Neuropati diabetik merupakan komplikasi adalah lamanya menderita diabetes, Peningkatan usia menyebabkan kemampuan tubuh berkurang dalam meredam aktivitas. 2018; 4(1): 40–5.

[40] Xie X, Liu Q, Wu J WM. Impact of cigarette smoking in type 2 diabetes development. 2009; 30(6) (784–7).

[41] Redita M. Pengaruh Perilaku Merokok Terhadap Kadar Glukosa Darah: Tinjauan Lamanya merokok Pada Pria Merokok Bersuku Tionghoa Indonesia. 2017; 17.

[42] Kusnanto K, Sundari PM, Asmoro CP, Arifin H. Hubungan Tingkat Pengetahuan dan Diabetes Self-Management dengan Tingkat Stres Pasien Diabetes Melitus yang Menjalani Diet. J Keperawatan Indones. 2019;22(1): 31–42.

[43] Firni Dwi Sari, Inayah MYH. Pola Penggunaan Obat Anti Hiperglikemik Oral pada Pasien Diabetes Melitus Tipe 2 Rawat Inap di Rumah Sakit X Pekanbaru Tahun 2014. Jom Fk. 2016; 3:1.