Implementation of Pharmaceutical Cost Containment Strategies in Indonesia: A Hospital-survey
DOI:
https://doi.org/10.22146/ijp.15048Keywords:
Implementation; Pharmaceutical; Cost Containment; HospitalsAbstract
The cost of healthcare services provided by hospital pharmacies has steadily increased. A systematic approach is required to overcome the challenges. One method involves the development of guidelines. This study aims to describe Indonesia's pharmaceutical cost containment strategy. The first part of this study consists of conducting a descriptive survey using a cross-sectional design, while the second part involves interviews to supplement the study. We used proportional stratified sampling based on the number of hospitals in Indonesia. The survey covered 101 hospitals. The second part of the survey included participants from six heads of pharmacy departments in Indonesian hospitals.
The survey shows that hospitals have only 17 pharmaceutical cost containment guidelines (15.45%). Only ten out of these 17 hospitals have well-functioning guidelines. According to the study, 84 participants (76.36%) indicated a need for guidelines. Forty participants used price negotiations as a strategy. The most effective approach is generic substitution/lowering, with 10 participants endorsing it. Only 17 (17%) hospitals have guidelines, and only ten of these have well-functioning guidelines.
The survey found that hospitals need systematic pharmaceutical cost containment based on clinical pathways that can be implemented in all hospitals.
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Boyd, M. R., Powell, B. J., Endicott, D., & Lewis, C. C. (2018). A Method for Tracking Implementation Strategies: An Exemplar Implementing Measurement-Based Care in Community Behavioral Health Clinics. Behavior Therapy, 49(4), 525–537. https://doi.org/10.1016/j.beth.2017.11.012
BPJS Kesehatan. (2016). Peraturan BPJS No. 8 Tahun 2016 tentang Penerapan Kendali Mutu dan Biaya Pada Penyelenggara Program Jaminan Kesehatan Nasional. 2069. www.peraturan.go.id
Durrani, H. (2016). Healthcare and healthcare systems: inspiring progress and future prospects. MHealth, 2(December 2015), 3. https://doi.org/10.3978/j.issn.2306-9740.2016.01.03
Ewbank, L., Omojomolo, D., Sullivan, K., & McKenna, H. (2018). The rising cost of medicines to the NHS. The Kings Fund, April, 2014–2018.
Fischer, F., Lange, K., Klose, K., Greiner, W., & Kraemer, A. (2016). Barriers and strategies in guideline implementation—a scoping review. Healthcare (Switzerland), 4(3), 1–16. https://doi.org/10.3390/healthcare4030036
Kemenkes RI. (2022). Profil Kesehatan Indonesia 2021. Kementerian Kesehatan Republik Indonesia.
Kim, W., Koo, H., Lee, H.-J., & Han, E. (2021). The Effects of Cost Containment and Price Policies on Pharmaceutical Expenditure in South Korea. International Journal of Health Policy and Management, x, 1–10. https://doi.org/10.34172/ijhpm.2021.135
Koushki, M. S., Goudarzi, R., Amiresmaili, M., Nekooei Moghaddam, M., Yazdi-Feyzabadi, V., & Talebian, A. (2023). Strategies of drugs cost containment in hospital: A systematic literature review. International Journal of Health Planning and Management, 38(1), 7–21. https://doi.org/10.1002/hpm.3542
Kumar Ramesh, Ismail Mohamed, & Sheriff Dhastagir Sultan. (2021). Effective Communication is the key for healthcare professionals. Mediterr J Pharm Pharm Sci, 1(3), 1–4. https://doi.org/10.5281/zenodo.5534557
Kwak, L., Lornudd, C., Björklund, C., Bergström, G., Nybergh, L., Elinder, L. S., Stigmar, K., Wåhlin, C., & Jensen, I. (2019). Implementation of the Swedish Guideline for Prevention of Mental ill-health at the Workplace: Study protocol of a cluster randomized controlled trial, using multifaceted implementation strategies in schools. BMC Public Health, 19(1), 1–19. https://doi.org/10.1186/s12889-019-7976-6
Laberge, M., Brundisini, F. K., Champagne, M., & Daniel, I. (2022). Hospital funding reforms in Canada: a narrative review of Ontario and Quebec strategies. Health Research Policy and Systems, 20(1), 1–17. https://doi.org/10.1186/s12961-022-00879-2
Rawabdeh, A. A. A. (2005). Health care cost containment strategies: The Jordanian experience. International Journal of Health Planning and Management, 20(1), 53–66. https://doi.org/10.1002/hpm.797
Regattieri, A., Bartolini, A., Cima, M., Fanti, M. G., & Lauritano, D. (2018). An innovative procedure for introducing the lean concept into the internal drug supply chain of a hospital. TQM Journal, 30(6), 717–731. https://doi.org/10.1108/TQM-03-2018-0039
Sanjaya, S., Sulistyo, D. H., & Hendrartini, J. (2022). Kinerja Tim Kendali Mutu Kendali Biaya Cabang Surakarta Dalam Pengendalian Mutu Dan Biaya Pada Program Jaminan Kesehatan Nasional. Jurnal Manajemen Pelayanan Kesehatan (The Indonesian Journal of Health Service Management), 22(1), 11–18. https://doi.org/10.22146/jmpk.v22i1.4472
Soewarno, N., & Tjahjadi, B. (2018). Factors Affecting Healthcare Costs in Indonesia: What the Hospitals and Doctors Said. August 2019, 768–775. https://doi.org/10.5220/0007021107680775
Stadhouders, N. (2019). Effective Healthcare Cost Containment Policies Using The Netherlands as A Case Study.
Stadhouders, N., Kruse, F., Tanke, M., Koolman, X., & Jeurissen, P. (2019). Effective Healthcare Cost-containment Policies: A Systematic Review. Health Policy, 123(1), 71–79. https://doi.org/10.1016/j.healthpol.2018.10.015
Swendrzynski, R. G. (2008). ASHP Guidelines on Medication Cost Management Strategies for Hospitals and Health Systems. American Journal of Health-System Pharmacy, 65(16), 1491. https://doi.org/10.2146/cor080011
Toropova, A., Björklund, C., Bergström, G., Elinder, L. S., Stigmar, K., Wåhlin, C., Jensen, I., & Kwak, L. (2022). Effectiveness of a multifaceted implementation strategy for improving adherence to the guideline for prevention of mental ill-health among school personnel in Sweden: a cluster randomized trial. Implementation Science, 17(1). https://doi.org/10.1186/s13012-022-01196-6
Van Dulmen, S. A., Maas, M., Staal, J. B., Rutten, G., Kiers, H., Nijhuis-Van, M., & van der Weers, P. (2014). Effectiveness of peer assessment for implementing a dutch physical therapy low back pain guideline: Cluster randomized controlled trial. Physical Therapy, 94(10), 1396–1409. https://doi.org/10.2522/ptj.20130286
Wasir, R., Irawati, S., Makady, A., Postma, M., Goettsch, W., Buskens, E., & Feenstra, T. (2019). Use of medicine pricing and reimbursement policies for universal health coverage in Indonesia. PLoS ONE, 14(2), 1–19. https://doi.org/10.1371/journal.pone.021232
Published
2026-07-23
How to Cite
Skarayadi, O., Endarti, D. ., Mukti, A. G., & Satibi, S. (2026). Implementation of Pharmaceutical Cost Containment Strategies in Indonesia: A Hospital-survey. Indonesian Journal of Pharmacy. https://doi.org/10.22146/ijp.15048
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Section
Research Article
