Search

Aisha Salsabilla,1 Alifia B Azzahra,1 Raden IP Syafitri,1 Woro Supadmi,2 Auliya A Suwantika1,3,4 1Department of Pharmacology and Clinical Pharmacy, Faculty of Pharmacy, Universitas Padjadjaran, Bandung, Indonesia; 2Faculty of Pharmacy, Universitas Ahmad Dahlan, Yogyakarta, Indonesia; 3Center of Excellence in Higher Education for Pharmaceutical Care Innovation, Universitas Padjadjaran, Bandung, Indonesia; 4Center for Health Technology Assessment, Universitas Padjadjaran, Bandung, IndonesiaCorrespondence: Auliya A SuwantikaDepartment of Pharmacology and Clinical Pharmacy, Faculty of Pharmacy, Universitas Padjadjaran, Bandung, IndonesiaEmail auliya@unpad.ac.idBackground: In the area where there is a lack of medical experts, telemedicine gives a lot of benefits to deal with the distance and limited public infrastructure.Objective: This study aimed to review the literature on the cost-effectiveness of telemedicine in Asian countries and possibly to provide recommendations on implementing telemedicine in this region.Methods: Articles were independently screened in two selected databases (PubMed and EBSCO). The framework of patient, intervention, comparison, and outcome (PICO) was applied by considering Asian population, the intervention of telemedicine, current situation (without telemedicine) as the comparator, and cost per QALY gained as the major outcome.Results: A total of 870 articles were identified from two databases: PubMed (n = 689 articles) and EBSCO (n = 181 articles). After removing 181 duplicates, 689 articles were screened by title and abstract, excluding 665 records. After the full-text screening on 24 articles, 8 articles were selected for further analysis. Various perspectives were applied in the included studies, such as societal, healthcare, and program perspectives. All studies applied different time horizons, such as 3-month, 25-year, 40-year, and lifetime. Among all included studies, several studies applied mathematical modeling.Conclusion: The implementation of telemedicine in Asia can be a promising intervention since it can enhance the effectiveness of health services by saving time and travel costs. It also can reduce the overall costs of treatment, improve patients’ quality of life, and expand access to essential health services.Keywords: cost per QALY gained, economic evaluation studies, cost utility analysis, cost-effective, cost saving

Abstract Background The HIV prevalence among injecting drug users (IDUs) in Indonesia reached 50% in 2005. While drug use remains illegal in Indonesia, a needle and syringe program (NSP) was implemented in 2006. Methods In 2007, an integrated behavioural and biological surveillance survey was conducted among IDUs in six cities. IDUs were selected via time-location sampling and respondent-driven sampling. A questionnaire was administered face-to-face. IDUs from four cities were tested for HIV, syphilis, gonorrhoea and chlamydia. Factors associated with HIV were assessed using generalized estimating equations. Risk for sexual transmission of HIV was assessed among HIV-positive IDUs. Results Among 1,404 IDUs, 70% were daily injectors and 31% reported sharing needles in the past week. Most (76%) IDUs received injecting equipment from NSP in the prior week; 26% always carried a needle and those who didn’t, feared police arrest. STI prevalence was low (8%). HIV prevalence was 52%; 27% among IDUs injecting less than 1 year, 35% among those injecting for 1–3 years compared to 61% in long term injectors (p Conclusions Although NSP uptake has possibly reduced HIV transmission among injectors with shorter injection history, the prevalence of HIV among IDUs in Indonesia remains unacceptably high. Condom use is insufficient, which advocates for strengthening prevention of sexual transmission alongside harm reduction programs.