ANALISIS UTILITAS BIAYA REGIMEN CHOP DIBANDINGKAN RCHOP PADA PASIEN LIMFOMA NON-HODGKIN DI RSUP DR. SARDJITO MENGGUNAKAN EQ-5D-5L: STUDI KOHORT
DOI:
https://doi.org/10.36423/pharmacoscript.v9i2.2842Keywords:
Analisis Utilitas Biaya, CHOP, EQ-5D-5L, Limfoma Non-Hodgkin, RCHOPAbstract
Secara global Limfoma Non-Hodgkin (LNH) merupakan salah satu keganasan hematologi dengan angka kejadian tertinggi dan menempati urutan ke-13 di dunia. Prevalensi di Asia selama lima tahun terakhir mencapai 710.721 kasus (40,9%) dengan 235.442 kasus baru (42,5%). Regimen Cyclophosphamide, Doxorubicin, Vinkristine, dan Prednisone (CHOP) merupakan kemoterapi konvensional, sedangkan RCHOP (Rituximab Cyclophosphamide, Doxorubicin, Vinkristine, dan Prednisone) merupakan imunokemoterapi dengan penambahan rituximab sebagai antibodi monoklonal anti-CD20 yang telah terbukti meningkatkan luaran klinis namun juga meningkatkan biaya terapi, sehingga diperlukan evaluasi farmakoekonomi. Penelitian ini bertujuan menganalisis biaya terapi medis langsung, kualitas hidup, dan utilitas biaya regimen CHOP dan RCHOP pada pasien LNH di RSUP Dr. Sardjito. Penelitian observasional kohort prospektif ini dilakukan dari perspektif rumah sakit dengan periode pengamatan selama satu siklus kemoterapi. Biaya medis langsung diperoleh dari rekam medis dan sistem pembiayaan rumah sakit. Kualitas hidup diukur menggunakan EQ-5D-5L dan dikonversi menjadi nilai utilitas menggunakan Indonesian EQ-5D-5L Value Set, kemudian dihitung Quality-Adjusted Life Years (QALYs) dan Incremental Cost-Utility Ratio (ICUR). Efektivitas biaya dinilai berdasarkan ambang batas cost-effectiveness sebesar satu kali Produk Domestik Bruto (PDB) per kapita Indonesia, tanpa dilakukan analisis sensitivitas. Sebanyak 60 pasien dianalisis, masing-masing 30 pasien pada kelompok CHOP dan RCHOP. Kelompok RCHOP memiliki kualitas hidup yang lebih baik (p<0,05), dengan nilai utilitas 0,97 dibandingkan 0,71 pada CHOP. Rata-rata biaya medis langsung terapi CHOP sebesar Rp 1.794.838 dan RCHOP sebesar Rp 7.930.518. Nilai ICUR sebesar Rp 316.762/QALY menunjukkan bahwa penambahan rituximab pada regimen CHOP memiliki cost-utility yang baik meskipun meningkatkan biaya terapi.
References
American Cancer Society. (2024). Non-Hodgkin Lymphoma, Causes, Risk Factors and Prevention. American Cancer Society, 1–12.
Andayani, T. M. (2013). Farmakoekonomi prinsip dan metodologi. Yogyakarta : Bursa Ilmu.
Betts, K. A., Thuresson, P., Felizzi, F., Du, E. X., Dieye, I., Li, J., Schulz, M., & Masaquel, A. S. (2020). US cost – effectiveness of polatuzumab vedotin , bendamustine and rituximab in diffuse large B-cell lymphoma.
Bhutani, V., Varzideh, F., Wilson, S., Kansakar, U., Jankauskas, S. S., & Santulli, G. (2025). Doxorubicin-Induced Cardiotoxicity : A Comprehensive Update. Journal of Cardiovascular Development and Disease, 12(207), 1–26.
Candelaria, M., & Dueñas-Gonzalez, A. (2021). Rituximab in combination with cyclophosphamide, doxorubicin, vincristine, and prednisone (R-CHOP) in diffuse large B-cell lymphoma. Herapeutic Advances in Hematology, 12, 1–14.
Chai, A. J. M., Leong, T. S., Lee, G. W. C., & Chew, d L. P. (2026). Retrospective analysis of diffuse large B-cell lymphoma treated with the R-CHOP regimen at a Malaysian tertiary hospital. World Journal of Surgical Oncology, 24(28).
Dholaria, B., Vanegas, Y. A. M., Diehl, N., Spaulding, A. C., Visscher, S., Tun, H. W., Ailawadhi, S., & Vishnu, P. (2020). Cost Analysis of R-CHOP Versus Dose-Adjusted R-EPOCH in Treatment of Diffuse Large B-Cell Lymphoma with High-Risk Features . Clinical Hematology International, 2(3), 117. https://doi.org/10.2991/chi.d.200410.001
Federico, M., Luminari, S., Dondi, A., Tucci, A., Vitolo, U., Rigacci, L., Raimondo, F. D. M. C., Pulsoni, Alessandro, Merli, F., Arcaini, L., Angrilli, F., Stelitano, C., Gaidano, G., Dell’Olio, M., Marcheselli, L., Franco, V., Galimberti, S., Sacchi, S., & Brugiatelli, M. (2013). R-CVP versus R-CHOP versus R-FM for the initial treatment of patients with advanced-stage follicular lymphoma: results of the FOLL05 trial conducted by the Fondazione Italiana Linfomi. Journal of Clinical Oncology: Official Journal of the American Society of Clinical Oncology, 31(12), 1506–1513. https://doi.org/https://doi.org/10.1200/JCO.2012.45.0866
Ferlay, J., Ervik, M., Lam, F., Laversanne, M., Colombet, M., Mery, L., Piñeros, M., Znaor, A., Soerjomataram, I., & Bray, F. (2024a). Global Cancer Observatory : Non-Hodgkin Lymphoma. International Agency for Research on Cancer. https://doi.org/10.1002/ijc.33588
Ferlay, J., Ervik, M., Lam, F., Laversanne, M., Colombet, M., Mery, L., Piñeros, M., Znaor, A., Soerjomataram, I., & Bray, F. (2024b). The Global Observatory : Indonesia. The Global Observatory.
Gustinanda, R., Irham, L. M., Supadmi, W., & Khair, R. El. (2025). Profil Penggunaan CHOP Dan RCHOP Pada Pasien Limfoma Non-Hodgkin Di RSUP DR. Sardjito. Jurnal Insan Farmasi Indonesia, 8(1), 164–178. https://doi.org/10.36387/jifi.v8i1.2529
Horwitz, S. M., Zelenetz, A. D., Gordon, L. I., Wierda, W. G., Abramson, J. S., Advani, R. H., Andreadis, C. B., Bartlett, N., Byrd, J. C., Fayad, L. E., Fisher, R. I., Glenn, M. J., Habermann, T. M., Harris, N. L., Hernandez-ilizaliturri, F., Hoppe, R. T., Kaminski, M. S., & Kelsey, C. R. (2016). Non-Hodgkin’s Lymphomas , Version 3 . 2016 Featured Updates to the NCCN Guidelines. Journal of the National Comprehensive Cancer Network, 14(9), 1067–1079.
Jogja Cancer Registry. (2023). Registrasi Kanker Berbasis Rumah Sakit Dr Sardjito/FKKMK UGM.
Johnson, P. C., Bailey, A., Ma, Q., Milloy, N., Butcher, J., Sanderson, I., Weatherby, S., Meadows, R., & Quek, R. G. W. (2024). Real-world evaluation of health-related quality of life in patients with diffuse large B-cell lymphoma based on a multinational survey. Frontiers in Oncology, June, 01–22. https://doi.org/10.3389/fonc.2024.1402992
Kementerian Kesehatan Republik Indonesia. (2016a). Panduan Penatalaksanaan Limfoma Non-Hodgkin. In Kementerian Kesehatan Republik Indonesia.
Kementerian Kesehatan Republik Indonesia. (2016b). Profil Kesehatan Indonesia. In Profil Kesehatan Indonesia Tahun 2015.
Kementerian Kesehatan Republik Indonesia. (2024). Rencana Kanker Nasional 2024-2034 : Strategi Indonesia dalam Upaya Melawan Kanker (Issue September 2024). Kementerian Kesehatan RI.
Kementerian Kesehatan Republik Indonesia. (2025). Pedoman Kajian Farmakoekonomi Dalam Pelayanan Kesehatan (pp. 1–53).
Kementerian Kesehatan RI. (2019). Laporan Riskesdas 2018 Nasional.
Li, Z., Jiang, W., Zhou, H., Cen, H., & Zhang, M. (2024). Comparison of zuberitamab plus CHOP versus rituximab plus CHOP for the treatment of drug- naïve patients diagnosed with CD20- positive diffuse large B- cell lymphoma : a phase 3 trial. 1–14. https://doi.org/10.1136/jitc-2024-008895
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Copyright (c) 2026 Ma'rifah Ma'rifah, Supadmi Woro, Irham Lalu Muhammad, Muliawati Retno, Gustinanda Rizky, Khair Riat El
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