The impacts of the health policy reform under the national health insurance on medicine use and treatment cost: A study on type-2 diabetic mellitus patients in Jakarta, Indonesia

ABSTRACT

This study was aimed to assess the impacts of policy reform under the Indonesian National Health Insurance (NHI) program called Jaminan Kesehatan Nasional on medicine use and treatment costs in type 2 diabetes mellitus (T2DM) outpatients. A longitudinal time-series design was conducted retrospectively to observe patient’s treatment and cost data to T2DM outpatients in five hospitals in Jakarta Province. The medicine use and treatment costs were compared before and after the NHI by Wilcoxon test. The 466 patients were included in the analysis. The implementation of the NHI had several impacts on decreasing medicine use indicators such as the average number of medicine prescribed, non-diabetes mellitus (DM) medicines the originator brand and generic products (p < 0.05). The cost of treatment, medicines and DM medicines also decreased (p < 0.05). However the cost of non-DM medicines did not change after the NHI implementation. The proportion of the cost of medicines to the cost of treatment was high; 70% of the cost of treatment was for medicines. In conclusion this study highlights the implementation of NHI had positive impacts on reducing medication usage and treatment costs. The high cost of medicines requires attention to prevent inefficiency in treatment.