"
ABSTRAKHipotiroid kongenital (HK) adalah kelainan bawaan yang dapat menimbulkan
dampak berupa retardasi mental permanen. Pemberian levothyroxine dengan dosis
tepat pada usia sedini mungkin, dapat mencegah gangguan pertumbuhan dan
perkembangan. Sayangnya, bayi baru lahir tidak menunjukkan gejala HK. Kalaupun
ada, berarti sudah ada gangguan pertumbuhan. Perlu skrining hipotiroid kongenital
(SHK) untuk menemukan kasus bayi yang menderita HK.
Meski sudah dilakukan sejak 2006, baru pada tahun 2014 dikeluarkan Permenkes
tentang pelaksanaan SHK di Indonesia. Penelitian evaluasi ekonomi program SHK
tahun 2014-2015 ini mencakup analisis biaya skrining dan terapi dini, sedangkan
outcome didapat dari systematic review (SR). Asumsi dikembangkan berdasarkan
data riil pasien skrining SHK di 2 laboratorium rujukan di Jakarta dan Bandung.
Dari total 56.186 bayi yang melakukan skrining, diperoleh 24 pasien positif
menderita HK.
Hasil SR menyatakan bahwa semakin dini onset terapi, semakin adekuat dosis
inisiasi dan semakin kontinyu terapi dapat memberikan hasil yang baik. Hasil
tersebut berupa pencegahan terhadap komplikasi HK lebih jauh dan perbaikan pada
penyimpangan tumbuh kembang.
Dari hasil penelitian, didapatkan informasi bahwa baru pada tahun kedua terlihat
adanya keuntungan ekonomis SHK. Hal ini berhubungan dengan patologi gejala HK
yang umumnya muncul pada usia 3-6 bulan. Orang tua baru mencari pertolongan
medis pada tahun kedua dan mengeluarkan lebih banyak biaya. Biaya skrining dan
terapi dini menjadi sepadan dibandingkan dengan kerugian yang dapat dicegah
akibat gejala gangguan tumbuh kembang.
ABSTRACTCongenital hypothyroidism (CH) is a congenital disorder that can have an impact in
the form of permanent mental retardation. Giving the right dose of levothyroxine at
the earliest possible age, can prevent the disruption of growth and development.
Newborns do not show symptoms of CH, and unfortunately the symptoms appear in
the late period and in many cases it shows growth disorders. The congenital
hypothyroidism screening (CHS) program has been implemented to find infant cases
with CH, and followed up with treatment.
Although it has been made since 2006, Minister of Health just issued the regulation
in 2014 on the implementation of CHS in Indonesia. This economic evaluation of the
CHS program in 2014-2015 was done using cost analysis, while outcome obtained
from the systematic review (SR). The assumptions used in the analysis were
developed based on real data from a CHS screening program in two referral
laboratories in Jakarta and Bandung. Out of 56.186 screened babies, 24 babies were
found as CH positive cases.
The result of the SR revealed that the earlier onset of initiation therapy, the more
adequate dose and the more continuous therapy given to the patient, the better result
will be achieved. It will prevent the patients from severe complications of CH and
will improve the quality of thegrowth and development..
The study found that the economic benefit is achieved in the second year of CH
treatment, since the pathological symptoms generally appear at the age of 3-6 month
and parents seek care in the second year. Consequently, cost to treat patients will
increase. The cost of screening and early treatment was found worthy as compared to
economic loss resulting from growth disorders."
