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ANALISIS SENSITIVITAS & ANALISIS DAMPAK BIAYA

Septiara Putri

Departemen Administrasi dan Kebijakan Kesehatan

Fakultas Kesehatan Masyarakat Universitas Indonesia

2022

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Gambaran umum

  • Apa yang dimaksud dengan ketidakpastian (uncertainty)?
  • Jenis analisis sensitivitas (SA)
  • Analisis dampak biaya (BIA)
  • Contoh dari SA dan BIA

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SENSITIVITY ANALYSIS

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Tahapan dalam Evaluasi Ekonomi

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Ketidakpastian

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Source: Kominski

  • Model ekonomi adalah proses yang berguna untuk mendukung pengambilan keputusan

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  • Ketidakpastian ada dalam evaluasi ekonomi

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  • Model menghasilkan hasil tunggal. Interpretasi dari hasil tersebut akan sangat tergantung pada tingkat kepercayaan, atau ketidakpastian dalam berbagai faktor

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Evaluasi pada Uncertainty

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Petrou S, Malek M, Davey PG. The reliability of costutility estimates in costperQALY league tables. PharmacoEconomics 1993;3:34553.

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Types of Uncertainty

Methodological

Modelling

Parameter

Generalizability/Transferability

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Tipe-tipe Analisis Sensitivitas

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  • Deterministic analysis
  • Analysis of extremes
  • Threshold analysis
  • Probabilistic sensitivity analysis (PSA)

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Cost Effectiveness Acceptability Curve

Cost Effectiveness Plane

Rituximab+CHOP for DLBCL patients in Indonesia

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BUDGET IMPACT ANALYSIS

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Budget Impact Analysis

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Estimate the financial consequences of the adoption and diffusion of a new strategy or technology in a health system

Financial changes that take place in a new scenario, in relation to the reference scenario

Important decision-making tool🡪 affordability and allocation. Short term costs

Complementary to economic evaluation

Country specific

Development of BIA method

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Evaluasi Ekonomi versus BIA

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Economic Evaluation

Budget Impact Analysis

Pertanyaan

Value for money?

Apakah terjangkau?

Tujuan

Efisiensi

Dampak finansial

Time horizon

Longer term (lifetime)

1-5 tahun

Luaran (kesehatan)

Included

Excluded

Perspektif

Societal, health care, patient, etc.

Payer/budget holder

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Sumber Data

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Prevalence and Incidence

    • Published literature review/report
    • Data epidemiology
    • Experts’ input or Delphi panel

Proportion of patients who can access the health technology (current and new)

    • Published literature review/report
    • Registry data
    • Claim data
    • Experts’ input or Delphi panel

Proportion from patient🡪 completely accessed health technology

    • Delphi panel, expert judgement
    • Projection from local data

Costs

    • Direct medical costs
    • Price of health technology

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Contoh 1: Rituximab+CHOP for DLBCL patients in Indonesia

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(S1): R-CHOP current price

(S2): R-CHOP 10% price reduced

(S3): R-CHOP 25% price reduced

(S4): R-CHOP 50% price reduced

(S5): R-CHOP 75% price reduced

(S6): CHOP current price

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Application of BIA �HTA Indonesia Studies

Contoh 2: Adding Cetuximab + chemotherapy for Metastatic Colorectal Cancer

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Application of BIA �HTA Indonesia Studies

Contoh 3: Continuous Ambulatory Peritoneal Dialysis vs Hemodialysis for ESRD Patients

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Kesimpulan

  • Ketidakpastian ada dalam evaluasi ekonomi kesehatan
  • Pentingnya menangani ketidakpastian dan melakukan analisis sensitivitas
  • Evaluasi ekonomi versus BIA

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TERIMA KASIH

septiaraputri@ui.ac.id

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