Cost-Effectiveness Analysis of Antibiotic Use in BPJS-Covered Pneumonia Patients at the Inpatient Unit of Hospital X / Analisis Efektivitas Biaya Penggunaan Antibiotik Pada Pasien BPJS Dengan Pneumonia Di Instalasi Rawat Inap Rumah Sakit X

Pneumonia is a lower respiratory tract infection that remains a major challenge to public health worldwide. The use of antibiotics as primary therapy is often irrational in terms of indications, dosage, and drug selection, which can impact clinical effectiveness and treatment costs. This study aims to assess the rationality and analyze the cost-effectiveness of antibiotic therapy for BPJS patients with pneumonia in the inpatient unit of Hospital X. This study is a non-experimental study with a descriptive observational method using the payer perspective (BPJS) approach. Data were collected retrospectively from the medical records of pneumonia patients from January 2023 to June 2025. Rationality was analyzed using the 4T method. Cost-effectiveness analysis was performed using the CEA method through ACER and ICER calculations. Based on the results of the rationality evaluation, it shows that the rationality of antibiotic use based on the 4T approach includes appropriate indications (100%), appropriate drugs (100%), appropriate patients (97.7%), appropriate dose (97.1%), appropriate frequency (100%), appropriate duration (98.8%), and appropriate route (100%). The total direct medical costs of patients with cefoperazone therapy were Rp 6,073,156, while those with ceftriaxone therapy were Rp 5,474,146. The ACER value of cefoperazone was Rp 65,614 per 1% clinical effectiveness, the ACER value of ceftriaxone was Rp 57,900 per 1% clinical effectiveness, while the ICER value was Rp 866,667 per additional 1% effectiveness.

Pneumonia merupakan infeksi saluran pernafasan bawah yang saat ini masih menjadi tantangan besar bagi kesehatan masyarakat di seluruh dunia. Penggunaan antibiotik sebagai terapi utama sering kali tidak rasional dalam hal indikasi, dosis, serta pemilihan obat, sehingga dapat memengaruhi efektivitas klinis dan biaya perawatan. Penelitian ini bertujuan menilai rasionalitas serta menganalisis efektivitas biaya penggunaan terapi antibiotik pasien BPJS dengan pneumonia di instalasi rawat inap Rumah Sakit X. Jenis penelitian ini adalah studi non-eksperimental dengan metode observasional deskriptif menggunakan pendekatan payer perspective (BPJS). Data dikumpulkan secara retrospektif dari rekam medis pasien pneumonia periode Januari 2023–Juni 2025. Rasionalitas dianalisis dengan metode 4T. Analisis efektivitas biaya dilakukan menggunakan metode CEA melalui perhitungan ACER dan ICER. Berdasarkan hasil evaluasi rasionalitas menunjukkan bahwa rasionalitas penggunaan antibiotik berdasarkan pendekatan 4T, meliputi tepat indikasi (100%), tepat obat (100%), tepat pasien (97,7%), tepat besaran dosis (97,1%), tepat frekuensi (100%), tepat durasi (98,8%), tepat rute (100%). Total biaya medis langsung pasien dengan terapi cefoperazon adalah Rp 6.073.156, sedangkan pasien dengan terapi ceftriaxon adalah Rp 5.474.146 . Nilai ACER cefoperazon sebesar Rp 65.614 per 1% efektivitas klinis, nilai ACER ceftriaxon sebesar Rp 57.900 per 1% efektivitas klinis, sedangkan nilai ICER yaitu diperoleh nilai sebesar Rp866.667 per tambahan 1% efektivitas.