SYSTEMATIC LITERATURE REVIEW: THE PATTERN OF PSYCHOTROPIC DRUG UTILIZATION IN THE JKN ERA

Abstract

Psychotropic drugs are essential in the management of mental disorders, yet their use often raises challenges related to rational prescribing, cost, and drug availability. Since the implementation of the Indonesian National Health Insurance (JKN) in 2014, changes in the utilization patterns of psychotropic medications have been observed and require systematic evaluation. This study aimed to review the prescribing patterns of psychotropic drugs in the JKN era, focusing on the most frequently used agents, therapeutic shifts, and their implications for healthcare access and financing. A systematic literature review was conducted using databases including Neliti, Garuda, ResearchGate, and Google Scholar. The search used the keywords “psychotropic,” “JKN,” “BPJS,” and “drug utilization.” Inclusion criteria were observational studies conducted in the Indonesian population between 2014 and 2025. From 124 identified publications, three articles met the inclusion criteria and were analyzed. The studies revealed a shift in the use of antipsychotics from typical to atypical agents, with risperidone as the most frequently prescribed. For antidepressants, selective serotonin reuptake inhibitors (SSRIs), particularly fluoxetine and sertraline, were commonly used, although amitriptyline remained an alternative due to limited drug availability. JKN contributed to improved patient access to treatment but was also associated with cost burden, unequal distribution of medicines, and risks of irrational prescribing. JKN has successfully expanded patient access to psychotropic therapy; however, it also introduced financial and prescribing challenges. Among mental health conditions, bipolar disorder showed a significant difference in annual costs between JKN and non-JKN patients, with higher costs under JKN mainly due to the high utilization of sodium divalproex.