Objective: In national health insurance (JKN) era, pharmacy can play roles in the form of behind refer pharmacies, or networking pharmacy and clinic pharmacy pratama. Behind refer pharmacies drug cost can be claimed directly to BPJS, meanwhile for the other type of pharmacy have to negotiation first with the primary health care. Drug cost variations in the JKN era affect the profitability of the business pharmacies. This research aims to the drug percentage charges against capitation and variety of drug costs. Methods:This research is analytic observational cross-sectional. This research uses secondary data from a JKN prescription patient. This research was conducted on 6 affiliated pharmacies, 6 networking pharmacies, and 7 clinical pharmacy pratama in DIY. The sampling in this research is by purposive with 8.430 prescriptions. Data drug costs JKN era was analyzed by descriptive statistics and comparative test (Kruskal Wallis test). Results:The result showed that average percentage of drug costs for capitation fee in the networking pharmacy is 13.58% and primary health care is 15.91%. Pharmacy in JKN era has drug cost variations (p=0.000). Drug cost in JKN era depends on the pattern of play roles with the health facilities and BPJS. The average percentage of drug costs against capitation health facilities in networking pharmacy is lower than clinical pharmacy pratama. Conclusions:Drug costs in an era of JKN depending on the pattern of cooperation with health facilities pharmacies and BPJS. The average percentage of the cost of drugs to the pharmacy capitation health facilities in networking lower than clinic pharmacy pratama. Differences in drug costs JKN era influenced by the long days of drug administration, the number of prescription sheets, margin.

<p><em>The Government of Indonesia has a lot of intervention for rationalizing drug use of all levels of health services including Primary Health Care. One of the programs of rational use of drugs at Primary Health Care is monitoring and evaluation of drug use conducted by pharmacist. The purpose of this research was to evaluate the rationality of drug usein Kuta Primary Health Care that review from WHO prescribing indicators and knowing the difference percentage of rationality of drug use between Kuta Primary Health Care. This research used cross sectional design research conducted in Kuta Primary Health Care on October 2017. Data analyzed using descriptive analysis and Kruskall-Wallis test. The average number of drug prescribed per en counter was 2.9. The percentage of drugs prescribed by generic drugs was 85.91percent. The percentage prescribed of encounters in which an antibiotic on ARI non Pneumonia was 29.94 pecent  and percentage prescribing antibiotic drugs in a non-specific diarrhea was 23.84 percent. The percentage prescribed of encounters injection was 0 percent. On the basic of the finding of this study the prescribed practices for polypharmacy, generic prescribing, and antibiotic shows deviation from the standard recommended by WHO and Directorate General of Pharmaceutical and Medical Devices Indonesia. These finding suggested increase health workers knowledge through scientific meetings or Focus Group Disscution (FGD) that can support a rational use of drugs in the Primary Health Care.</em></p><p> </p><p>Pemerintah Indonesia telah banyak melakukan intervensi untuk merasionalkan penggunaan obat dari segala tingkat pelayanan kesehatan termasuk Puskesmas. Salah satu program Penggunaan Obat Rasional (POR) di Puskesmas adalah monev penggunaan obat yang dilakukan oleh farmasis. Tujuan penelitian ini adalah melakukan evaluasi rasionalitas penggunaan obat di Puskesmas Kecamatan Kuta ditinjau dari indikator peresepan (% peresepan obat generik, % persentase antibiotik, % peresepan injeksi) dan mengetahui perbedaan persentase rasionalitas penggunaan obat antar Puskesmas Kecamatan Kuta. Penelitian ini menggunakan rancangan penelitian<em> cross sectional </em>yang dilakukan pada Puskesmas Kuta I, Kuta II, dan Kuta Utara pada bulan Oktober 2017. Analisis data menggunakan analisis deskriptif dan uji Kruskall-Wallis. Analisis deskriptif dari tenaga kesehatan menunjukkan bahwa, profesi Apoteker masih langka di Puskesmas Kecamatan Kuta yaitu hanya ada di Puskesmas Kuta 1 per November 2018. Hasil penelitian tiap parameter pada Puskesmas Kecamatan Kuta tidak ada yang memenuhi target kriteria POR dari target Dirjen Binfar kecuali parameter peresepan injeksi. Rata-rata obat tiap pasien adalah 2,9, % peresepan obat generik adalah 85,91%, % peresepan obat antibiotik pada ISPA non Pneumonia adalah 29,94%, % peresepan obat antibiotik pada diare non spesifik adalah 23,84%, dan % peresepan injeksi adalah 0%. Hal tersebut menunjukkan bahwa Puskesmas Kecamatan Kuta masih mengalami masalah polifarmasi dan penggunaan antibiotik berlebihan. Hasil penelitian ini dapat menunjukkan adanya kebutuhan untuk meningkatkan pengetahuan tenaga kesehatan melalui pertemuan ilmiah atau <em>Focus Group Disscution (</em>FGD) yang dapat mendukung penggunaan obat yang rasional di Puskesmas.</p>

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