Pharmacoeconomic Assessment Using ACER and ICER Methods for Cost Efficiency of Antibiotics in Pneumonia Patients at Grha Bhakti Medika Hospital, Klungkung, Bali, January-December 2023

Introduction: Pneumonia significantly contributes to the high death rate and disease burden in Indonesia. Cost efficiency analysis is a pharmacoeconomic method used for selecting and assessing the best program or drug for several therapeutic options with the same goal. This study aimed to compare the combination of ceftriaxone-azithromycin with levofloxacine alone as an antibiotic for hospitalized pneumonia patients. Methods: This research involved calculating the Average Cost-Effectiveness Ratio (ACER) and Incremental Cost-Effectiveness Ratio (ICER). The study was carried out at Grha Bhakti Medika Hospital Klungkung, Bali, using a retrospective cross sectional descriptive research design, where data collected retrospectively form patient medical records from January to December 2023. Forty patients participated, with 20 receiving the combination of ceftriaxone-azithromycin and 20 receiving levofloxacine alone. Results: The ACER value for the levofloxacine group was IDR 13,247.-, while, the ACER value for the ceftriaxone-azithromycin group was IDR 7,773. The efficiency of using levofloxacine was 75%, while the efficiency of using the ceftriaxone-azithromycin combination was 85%. The ICER calculation yielded a value of - IDR 547,-. The mean ACER value for the levofloxacine group was significantly different from that of the ceftriaxone-azithromycin group. The cost of treating pneumonia patients with ceftriaxone-azithromycin was lower than with levofloxacine. Conclusion: The ceftriaxone-azithromycin combination was proven to be more effective and efficient in treating pneumonia according to the ACER and ICER assessment.