Drug Utilization Review terhadap Penggunaan dan Biaya Obat Antihipertensi pada Pasien Polifarmasi di Sembilan Rumah Sakit Kabupaten Kulon Progo Tahun 2024–2025

Hypertension is a chronic disease that requires long-term treatment and is often accompanied by the use of multiple medications, particularly in patients with comorbidities. This study aimed to evaluate the utilization patterns and costs of antihypertensive drugs among patients with polypharmacy in nine hospitals in Kulon Progo Regency during 2023–2025 using a Drug Utilization Review (DUR) approach. The study employed a retrospective, descriptive, observational design with aggregate longitudinal analysis of prescription and National Health Insurance (JKN) claims data from September 2023 to December 2025. Samples were selected through total sampling of polypharmacy prescriptions, defined as those containing ≥6 generic drugs and at least one antihypertensive. Drug utilization was analyzed using the Anatomical Therapeutic Chemical/Defined Daily Dose (ATC/DDD) classification and the Drug Utilization 90% (DU90%) method. Of 9,336 participants, most were female (54.0%) and aged ≥60 years (51.0%). Polypharmacy was most commonly found in prescriptions containing six drugs. Antihypertensive drugs included in the DU90% segment were candesartan (39.10%), amlodipine (33.44%), bisoprolol (12.42%), and furosemide (12.19%). The highest accumulated drug cost was recorded at Hospital 1, at IDR 10,652,208,824, followed by Hospitals 3 and 2. These findings indicate variation in antihypertensive drug utilization among patients with polypharmacy, suggesting the need for periodic evaluation of treatment rationality, adherence to the National Formulary, and optimization of generic drug use to support efficient JKN healthcare expenditure.