Analisis efektivitas biaya pengobatan terapi kelasi besi deferiprone (DFP) dan deferasirox (DFX) tablet pada pasien thalassemia mayor dewasa

Background: Thalassemia is a blood disorder caused by abnormalities in hemoglobin. Thalassemia major is a red blood cell disorder that requires high costs because patients need regular blood transfusions and must take iron chelating drugs such as deferiprone and deferasirox throughout their lives to bind serum iron levels. Purpose: To analyze the cost-effectiveness of iron chelation therapy deferiprone (DFP) and deferasirox (DFX) tablets in adult thalassemia major patients. Method: Non-experimental research using a retrospective cohort method was conducted from August to December 2024 at Fatmawati Central General Hospital in Jakarta. The sampling technique used consecutive sampling with a total of 56 respondents divided into two groups. The independent variable in this study was the type of iron chelation therapy, while the dependent variable was cost effectiveness. Cost analysis was performed by calculating the total treatment costs for each therapy group using the incremental cost-effectiveness ratio (ICER). Results: The average total cost of treatment for patients with thalassemia major using deferasirox was Rp10,377,479, which was higher than that of deferiprone at Rp10,055,475. Deferasirox is more effective in reducing serum iron levels, namely 1,786 ng/mL, compared to deferiprone, which only reaches 865 ng/mL. The cost per unit of effectiveness of deferasirox therapy is IDR 5,809, which is lower than deferiprone at IDR 11,629. The incremental cost-effectiveness ratio (ICER) value shows that switching therapy from deferiprone to deferasirox requires an additional cost of Rp349 for each unit of increased effectiveness. Conclusion: Deferasirox can be the primary choice of iron chelation therapy in adult thalassemia patients, considering its clinical effectiveness and cost efficiency. Keywords: Adult Thalassemia Major Patients; Deferasirox (DFX) Tablets; Iron Chelation Deferiprone (DFP); Therapy; Treatment Costs. Pendahuluan: Thalasemia adalah kelainan darah yang disebabkan oleh kelainan pada hemoglobin. Thalasemia mayor merupakan gangguan sel darah merah yang membutuhkan biaya tinggi karena pasien memerlukan darah secara rutin dan sepanjang hidupnya harus mengonsumsi obat pengikat zat besi seperti deferiprone dan deferasirox untuk mengikat kadar Fe serum. Tujuan: Untuk menganalisis efektivitas biaya pengobatan terapi kelasi besi deferiprone (DFP) dan deferasirox (DFX) tablet pada pasien thalassemia mayor dewasa. Metode: Penelitian non-eksperimental dengan metode cohort retrospektif, dilaksanakan bulan Agustus-Desember 2024 di Rumah Sakit Umum Pusat Fatmawati Jakarta. Teknik pengambilan sampel menggunakan consequtive sampling dengan jumlah sampel yang digunakan sebanyak 56 responden yang dibagi menjadi dua kelompok. Variabel independen dalam penelitian ini adalah jenis terapi kelasi besi, sedangkan variabel dependen adalah efektivitas biaya. Analisis biaya dengan menghitung total biaya pengobatan pada masing-masing kelompok terapi menggunakan incremental cost-effectiveness ratio (ICER). Hasil: Rata-rata total biaya pengobatan pasien thalassemia mayor yang menggunakan deferasirox adalah sebesar Rp10,377.479, lebih tinggi dibandingkan dengan deferiprone sebesar Rp10,055.475. Efektivitas deferasirox dalam menurunkan kadar serum besi lebih besar, yaitu 1,786 ng/mL, dibandingkan dengan deferiprone yang hanya mencapai 865 ng/mL. Biaya per unit efektivitas terapi deferasirox adalah Rp5,809, lebih rendah dibandingkan deferiprone sebesar Rp11,629. Nilai incremental cost-effectiveness ratio (ICER) menunjukkan bahwa untuk mengganti terapi dari deferiprone ke deferasirox diperlukan tambahan biaya sebesar Rp349 untuk setiap satuan peningkatan efektivitas. Simpulan: Deferasirox dapat menjadi pilihan utama terapi kelasi besi pada pasien Thalasemia dewasa dengan mempertimbangkan efektivitas klinis dan efisiensi biaya. Kata Kunci: Biaya Pengobatan; Deferasirox (DFX) Tablet; Kelasi Besi Deferiprone (DFP); Pasien Thalassemia Mayor Dewasa; Terapi.