COMPARATIVE ANALYSIS OF DRUG COSTS BASED ON THE ACTIVITY-BASED COSTING METHOD AND DRUG PRICE RATES, INCLUDING THE EVALUATION OF COST DIFFERENCES AND MANAGERIAL IMPLICATIONS IN THE PHARMACY UNIT OF MARTHA FRISKA MULTATULI HOSPITAL
Keywords:
Activity-Based Costing, Traditional Unit Cost, ABC Unit Cost, Undercosting, Actual Margin, Tariff Deviation, Managerial ImplicationsAbstract
This study aims to analyze the difference between drug Unit Cost calculated using Activity-Based Costing (ABC) and Traditional Unit Cost, and to evaluate its implications for actual margin and tariff policy in the Pharmacy Unit of Martha Friska Multatuli Hospital. A quantitative approach with a descriptive-comparative design was applied. The data were secondary data for the year 2025, comprising drug purchasing records, sales records, selling prices, transaction volume, receipt frequency, and the indirect costs of the pharmacy unit. The sample consisted of 100 drug items with the highest sales volume and complete data, selected through purposive sampling. The results show that the mean ABC Unit Cost was IDR 1,427.62, while the mean Traditional Unit Cost was IDR 1,249.08. The Jarque-Bera normality test indicated that the cost-difference data were not normally distributed, so the Wilcoxon Signed-Rank Test was used and revealed a significant difference between ABC Unit Cost and Traditional Unit Cost (p < 0.001), with a large effect size (r = 0.868). All sampled drugs were undercosted under the traditional system. Tariff evaluation using a 20% target margin showed that 79 drugs exhibited a positive tariff deviation and 21 drugs exhibited a negative tariff deviation relative to the ABC-based proposed tariff. These findings indicate that ABC strengthens pharmacy cost information, supports the evaluation of actual margins, and provides a basis for prioritizing drug-tariff review. The managerial implications include strengthening the hospital's Unit Cost Team, improving the recording of pharmacy activities, integrating pharmacy data systems, and conducting periodic tariff evaluation based on activity costs and actual margins.
References
Anggriani, Y., Ramadaniati, H. U., Sarnianto, P., Pontoan, J., & Suryawati, S. (2020). The impact of pharmaceutical policies on medicine procurement pricing in Indonesia under the implementation of Indonesia's social health insurance system. Value in Health Regional Issues, 21, 1–8. https://doi.org/10.1016/j.vhri.2019.05.005
Cohen, J. (1988). Statistical power analysis for the behavioral sciences (2nd ed.). Lawrence Erlbaum Associates.
da Silva Etges, A. P. B., Cruz, L. N., Notti, R. K., Neyeloff, J. L., Schlatter, R. P., Astigarraga, C. C., Falavigna, M., & Polanczyk, C. A. (2019). An 8-step framework for implementing time-driven Activity-Based Costing in healthcare studies. The European Journal of Health Economics, 20(8), 1133–1145. https://doi.org/10.1007/s10198-019-01085-8
Dolcini, M., Sofia, B., Marco, R., Brambilla, A., Silvia, M., Francesca, T., & Stefano, C. (2025). Facility management costs for hospital infrastructures: Insights from the Italian healthcare system. Healthcare, 13(8), 924. https://doi.org/10.3390/healthcare13080924
Etges, A. P. B. da S., Ruschel, K. B., Polanczyk, C. A., & Urman, R. D. (2020). Advances in value-based healthcare by the application of time-driven Activity-Based Costing for inpatient management: A systematic review. Value in Health, 23(6), 812–823. https://doi.org/10.1016/j.jval.2020.02.004
Fuzi, N. M., Adam, S., Ramdan, M. R., Ong, S. Y. Y., Osman, J., Kolandan, S., Ariffin, S. Z. M., Jamaluddin, N. S., & Abdullah, K. (2022). Sustainability management accounting and organizational performance: The mediating role of environmental management system. Sustainability, 14(21), 14290. https://doi.org/10.3390/su142114290
Ghozali, I. (2018). Aplikasi analisis multivariate dengan program IBM SPSS 25 (9th ed.). Badan Penerbit Universitas Diponegoro.
Huang, W.-H., & Cheng-Tsung, L. (2025). The effect of hospital budgeting system on physician-executives' budget cognitive consciousness and medical decision making. Cost Effectiveness and Resource Allocation, 23, 1–23. https://doi.org/10.1186/s12962-025-00629-5
Keel, G., Savage, C., Rafiq, M., & Mazzocato, P. (2017). Time-driven Activity-Based Costing in health care: A systematic review of the literature. Health Policy, 121(7), 755–763. https://doi.org/10.1016/j.healthpol.2017.04.013
Kim, H.-Y. (2021). Statistical notes for clinical researchers: Assessing normal distribution using skewness and kurtosis. Restorative Dentistry & Endodontics, 46(1), e5.
Kludacz-Alessandri, M. (2020). The relationship between cost system functionality, management accounting practices, and hospital performance. Foundations of Management, 12(1), 223–236. https://doi.org/10.2478/fman-2020-0017
Kwenda, F., & Harrison, T. F. (2025). The effects of management accounting practices on financial performance of manufacturing small and medium enterprises in Zimbabwe. The Journal of Accounting and Management, 15(1).
Leusder, M., Porte, P., Ahaus, K., & van Elten, H. (2022). Cost measurement in value-based healthcare: A systematic review. BMJ Open, 12(12), e066568. https://doi.org/10.1136/bmjopen-2022-066568
Li, Y., Liang, S., Qin, K., Su, H., & Xia, P. (2024). Itemized point cost method in human resource cost accounting in medical service projects. Cost Effectiveness and Resource Allocation, 22, 1–16. https://doi.org/10.1186/s12962-024-00599-0
Lulaj, E. (2025). Penny-wise acumen in costonomics: Transforming costs into entrepreneurial gold through smart financial management. Journal of Risk and Financial Management, 18(1), 9. https://doi.org/10.3390/jrfm18010009
Mahesha, M. (2022). Traditional costing system versus activity based costing system: A conceptual review. International Journal of Case Studies in Business, IT, and Education, 6(1), 217–225.
Moghaddasi, S., Kordani, K., Sarvari, H., & Rashidi, A. (2025). Redefining project management: Embracing value delivery offices for enhanced organizational performance. Buildings, 15(7), 1176. https://doi.org/10.3390/buildings15071176
Morgan, D., & Xiang, F. (2022). Improving data on pharmaceutical expenditure in hospitals and other health care settings (OECD Health Working Papers No. 139). OECD Publishing. https://doi.org/10.1787/6c0d64a2-en
Niñerola, A., Hernández-Lara, A. B., & Sánchez-Rebull, M. V. (2021). Improving healthcare performance through Activity-Based Costing and time-driven activity-based costing. The International Journal of Health Planning and Management, 36(6), 2079–2093. https://doi.org/10.1002/hpm.3304
Popesko, B., Papadaki, Š., & Novák, P. (2015). Cost and reimbursement analysis of selected hospital diagnoses via activity-based costing. E&M Economics and Management, 18(3), 50–61. https://doi.org/10.15240/tul/001/2015-3-005
Quesado, P., & Silva, R. (2021). Activity-Based Costing (ABC) and its implication for open innovation. Journal of Open Innovation: Technology, Market, and Complexity, 7(1), 41. https://doi.org/10.3390/joitmc7010041
Rahmawati, A., & Daengs GS, A. (2021). Implementasi Activity Based Costing terhadap perhitungan biaya operasional pada unit layanan rumah sakit X Surabaya. Jurnal Riset Akuntansi Aksioma, 20(1), 13–32. https://doi.org/10.29303/aksioma.v20i1.122
Robinson, J. C., Whaley, C., & Dhruva, S. S. (2024). Hospital prices for physician-administered drugs for patients with private insurance. The New England Journal of Medicine, 390(4), 338–345. https://doi.org/10.1056/NEJMsa2306609
Schober, P., & Vetter, T. R. (2020). Nonparametric statistical methods for the analysis of paired samples. Anesthesia & Analgesia, 131(6), 1862–1863. https://doi.org/10.1213/ANE.0000000000005134
Seto, A., Irwan, M., Andri, H., Puspa, H. A., & Afden, M. (2025). Cost efficiency analysis in integrated cadastre mapping system through an operational management approach. Land, 14(4), 699. https://doi.org/10.3390/land14040699
Setyaning, L. B., & Fara Dita, A. O. (2020). Literature study: Activity-Based Costing system. Journal of Applied Sciences, Management and Engineering Technology, 1(2), 46–49. https://doi.org/10.31284/j.jasmet.2020.v1i2.1160
Sugiyono. (2019). Metode penelitian pendidikan (kuantitatif, kualitatif, kombinasi, R&D dan penelitian pendidikan). Alfabeta.
Špacírová, Z., Rejon-Parrilla, J. C., & Espín, J. (2026). The complex price setting and reimbursement of non-industrial advanced therapy medicinal products. Health Policy, 143, 105048.
Vanderlee, A., Armitstead, J. A., Darnell, J., & Lozano, Y. (2023). Impact of acute-care pharmacy services on health system skilled nursing locations. Journal of Hospital Management and Health Policy, 7, 23. https://doi.org/10.21037/jhmhp-23-27
Wang, Y. (2025). The role of management accounting in supporting strategic decision-making: Evidence and implications. Journal of Accounting and Management Research, 10(1), 1–15.
Xu, X., Ansah, J. P., De Korne, D. F., Chen, Q., Klein, M. B., Ong, M. E. H., & Matchar, D. B. (2021). Optimizing the allocation of a hospital's resources for its healthcare workers: A systematic review of cost-measurement methods. Cost Effectiveness and Resource Allocation, 19, 1–12.
Yang, W., Xu, R., Chen, D., Wu, J., & Wang, K. (2025). Cost accounting systems and healthcare pricing: An institutional perspective. Health Economics Review, 15, 1–14.
Downloads
Published
How to Cite
Issue
Section
License
Copyright (c) 2026 Ramadhan Diansyah Putra, Erlina, Ibnu Austrindanney Sina Azhar
This work is licensed under a Creative Commons Attribution 4.0 International License.
