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Submitted
February 8, 2021
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October 22, 2022
Published
December 30, 2022
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Abstract

Background: Severe Cutaneous Adverse Reactions (SCARs), including Stevens-Johnson Syndrome (SJS), Toxic Epidermal Necrolysis (TEN), and Drug Reaction with Eosinophilia and Systemic Symptom (DRESS), were the idiosyncratic reactions most commonly caused by drugs which have an impact on increasing the patient's financial burden.


Objectives: This study aims to determine the highest cost component and the illness cost in patients suffering from Severe Cutaneous Adverse Reactions (SCARs).


Methods: This study was an analytic observational study with a cross-sectional design. We collected direct medical costs, direct non-medical costs, and indirect costs for inpatients with SJS, TEN, and DRESS at Dr. Sardjito Yogyakarta Hospital from 2014-2018, retrospectively. Based on the societal perspective, we defined the highest cost component and the illness cost in patients with SCARs.


Results: The highest cost component for SJS, and TEN patients were obtained in the health professional services (24,1% and 25,2%, respectively). Meanwhile, the highest cost component for DRESS patients was the cost of drugs (20,2%). The total illness cost of 47 SCARs patients (22 SJS patients, 6 TEN patients, and 19 DRESS patients) was IDR 666.615.321, with the highest average cost for TEN patients, followed by SJS and DRESS (IDR 16.510.595, IDR 14.205.545, and IDR 13.445.555, respectively).


Conclusions: The highest cost component was the health professional services in SJS and TEN patients and the cost of medicine for DRESS patients. The management of SCARs requires considerable cost, and it is still being a financial burden on the patients.

Keywords

Cost analysis societal perspective severe cutaneous adverse reactions

Article Details

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Author Biographies

Qarriy 'Aina Urfiyya, Akademi Farmasi Indonesia Yogyakarta

Dyah Aryani Perwitasari, Fakultas Farmasi, Universitas Ahmad Dahlan

Sri Awalia Febriana, Departemen Dermatologi dan Venerologi Fakultas Kedokteran, Universitas Gadjah Mada/RSUP. Dr. Sardjito

Woro Supadmi, Fakultas Farmasi, Universitas Ahmad Dahlan

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References

  1. Abdulah, R., Suwandiman, T. F., Handayani, N., Destiani, D. P., Suwantika, A. A., Barliana, M. I., & Lestari, K. (2017). Incidence, Causative Drugs, and Economic Consequences of Drug-Induced SJS, TEN, and SJS-TEN Overlap and Potential Drug-Drug Interactions during Treatment: A Retrospective Analysis at An Indonesian Referral Hospital. Ther Clin Risk Manag, 13, 919-925. https://doi.org/10.2147/tcrm.S142226
  2. Chantaphakul, H., Sanon, T., & Klaewsongkram, J. (2015). Clinical Characteristics and Treatment Outcome of Stevens-Johnson Syndrome and Toxic Epidermal Necrolysis. Exp Ther Med, 10(2), 519-524. https://doi.org/10.3892/etm.2015.2549
  3. Frey, N., Jossi, J., Bodmer, M., Bircher, A., Jick, S. S., Meier, C. R., & Spoendlin, J. (2017). The Epidemiology of Stevens-Johnson Syndrome and Toxic Epidermal Necrolysis in the UK. J Invest Dermatol, 137(6), 1240-1247. https://doi.org/10.1016/j.jid.2017.01.031
  4. Kemenkes_RI. (2018). Profil Kesehatan Indonesia Tahun 2017. Jakarta
  5. Lihite, R. J., Lahkar, M., Borah, A., Hazarika, D., & Singh, S. (2016). A Study on Drug Induced Stevens-Johnson Syndrome (SJS), Toxic Epidermal Necrolysis (TEN) and SJS-TEN Overlap in A Tertiary Care Hospital of Northeast India. Journal of Young Pharmacists, 8(2), 149-153 https://doi.org/https://dx.doi.org/10.5530/jyp.2016.2.18
  6. Lin, Y. F., Yang, C. H., Sindy, H., Lin, J. Y., Rosaline Hui, C. Y., Tsai, Y. C., Wu, T. S., Huang, C. T., Kao, K. C., Hu, H. C., Chiu, C. H., Hung, S. I., & Chung, W. H. (2014). Severe Cutaneous Adverse Reactions Related to Systemic Antibiotics. Clin Infect Dis, 58(10), 1377-1385. https://doi.org/10.1093/cid/ciu126
  7. Manchanda, Y., Das, S., Sarda, A., & Biswas, P. (2018). Controversies in the Management of Cutaneous Adverse Drug Reactions. Indian J Dermatol, 63(2), 125-130. https://doi.org/10.4103/ijd.IJD_585_17
  8. Patel, T. K., Barvaliya, M. J., Sharma, D., & Tripathi, C. (2013). A Systematic Review of the Drug-Induced Stevens-Johnson Syndrome and Toxic Epidermal Necrolysis in Indian Population. Indian J Dermatol Venereol Leprol, 79(3), 389-398. https://doi.org/10.4103/0378-6323.110749
  9. Purnamawati, S., Febriana, S. A., Danarti, R., & Saefudin, T. (2016). Topical Treatment for Stevens - Johnson Syndrome and Toxic Epidermal Necrolysis: A Review. Bali Medical Journal, 5(1), 82-90. https://doi.org/doi: 10.15562/bmj.v5i1.274.
  10. Rahmawati, Y. W., & Indramaya, D. M. (2016). Studi Retrospektif: Sindrom Stevens-Johnson dan Nekrolisis Epidermal Toksik (A Retrospective Study: Stevens-Johnson Syndrome and Toxic Epidermal Necrolysis). Berkala Ilmu Kesehatan Kulit dan Kelamin – Periodical of Dermatology and Venereology, 28(2), 68–76.
  11. Teng, C. (2011). A guide on guidelines. Malays Fam Physician, 6(1), 1.
  12. Velasco-Tirado, V., Alonso-Sardón, M., Cosano-Quero, A., Romero-Alegría, Á., Sánchez-Los Arcos, L., López-Bernus, A., Pardo-Lledías, J., & Belhassen-García, M. (2018). Life-threatening dermatoses: Stevens-Johnson Syndrome and Toxic Epidermal Necrolysis. Impact on the Spanish public health system (2010-2015). PLoS One, 13(6), e0198582. https://doi.org/10.1371/journal.pone.0198582
  13. Wang, L., & Mei, X. L. (2017). Drug Reaction with Eosinophilia and Systemic Symptoms: Retrospective Analysis of 104 Cases over One Decade. Chin Med J (Engl), 130(8), 943-949. https://doi.org/10.4103/0366-6999.204104
  14. Wolfson, A. R., Zhou, L., Li, Y., Phadke, N. A., Chow, O. A., & Blumenthal, K. G. (2019). Drug Reaction with Eosinophilia and Systemic Symptoms (DRESS) Syndrome Identified in the Electronic Health Record Allergy Module. J Allergy Clin Immunol Pract, 7(2), 633-640. https://doi.org/10.1016/j.jaip.2018.08.013
  15. Yang, M. S., Kim, J. Y., Kang, M. G., Lee, S. Y., Jung, J. W., Cho, S. H., Min, K. U., & Kang, H. R. (2019). Direct Costs of Severe Cutaneous Adverse Reactions in A Tertiary Hospital in Korea. Korean J Intern Med, 34(1), 195-201. https://doi.org/10.3904/kjim.2015.365