Nyeri pada kanker merupakan permasalahan kompleks yang dapat menurunkan kualitas hidup survivor kanker. Penatalaksanaan nyeri kanker secara komprehensif diperlukan untuk meningkatkan keberhasilan terapi, termasuk dalam efektifitas serta biaya yang diperlukan. Tujuan penelitian ini adalah untuk memperoleh gambaran perbandingan efektifitas, keamanan dan biaya terapi nyeri kanker dengan fentanyl transdermal dan morfin oral sustained release (MST) di Rumah Sakit Kanker Dharmais (RSKD). Jenis penelitian ini adalah deskriptif dengan metode pengambilan data retrospektif dari penelusuran data catatan medik pasien dan data biaya penggunaan obat. Subjek penelitian adalah pasien kanker solid rawat inap di RSKD periode Januari hingga Desember 2011 yang memenuhi kriteria inklusi. Data efektifitas diperoleh dari pengukuran skala nyeri, menggunakan Visual Analogue Scale (VAS) yang tercatat pada catatan medik. Analisa data efektifitas berdasarkan persentase subyek penelitian yang mencapai skala ringan dalam waktu kurang dari 7 hari (target terapi). Biaya terapi meliputi biaya kelompok terapi, biaya terapi adjuvant dan biaya adverse event. Uji Mann Whitney dilakukan untuk mengetahui perbandingan biaya terapi nyeri rata-rata, yang mencapai target terapi. Efektifitas fentanyl transdermal lebih tinggi (45, 24%) dibandingkan dengan morfin oral sustained release (31, 58%). Persentase terjadinya konstipasi dan nausea/vomitus pada fentanyl transdermal 26, 19% dan 7, 12% pada morfin oral MST 47, 38% dan 7, 89%. Biaya total rata-rata fentanyl transdermal dan morfin oral MST hingga tercapai target terapi yaitu Rp 449.544, 11±Rp 433.371, 00 dan Rp365. 403, 17±Rp 267.452, 00 (p= 0,465).

Cancer pain is a complex problem that may decrease cancer survivors’ quality of life. A comprehensive cancer pain management is necessary to improve therapy success, including its effectiveness and required costs. This research was aimed at obtaining a description of comparisan of the effectiveness, safety and cost between cancer pain therapy using fentanyl transdermal and sustained release oral morphine at Dharmais Cancer Hospital (RSKD) The research belongs to descriptive research using retrospective data collection obtained from data investigation to patients’ medical record and cost of medical use data. The subjects of the research were solid cancer inpatients who met the inclusion criteria at RSKD from January until December 2011. Effectiveness data were obtained from the measurement of pain scale using Visual Analogue Scale (VAS) recorded in medical record. The effectiveness data were analyzed based on the percentage of the research subjects who achieved mild scale within less than 7 days (therapy target). Therapy cost included therapy group cost, adjuvant therapy cost and adverse event cost. Mann Whitney test was conducted to identify the comparison of the average of pain therapy cost, which achieved therapy target. The effectiveness of fentanyl transdermal was higher (45.24%) than that of sustained release oral morphine (31.58%). The precentage of the occurence of constipation and nausea/vomiting on fentanyl transdermal was 26.19% dan 7.12% and on sustained release oral morphine was 47.38% dan 7. 89%. The total cost of the average of fentanyl transdermal and sustained release oral morphine until achieving the therapy target were Rp 449,544.11 ±Rp 433,371.00 and Rp365, 403.17 ±Rp 267,452.00 (p= 0.465).