Cost-Effectiveness Analysis of Pitavastatin in Dyslipidemia: Vietnam Case

Background/Objectives: Dyslipidemia is becoming a significant economic healthcare burden in low- to middle-income countries (LMICs) due to its role in heightening cardiovascular-related mortality. Statins are the first-line treatment for reducing LDL-C levels, thereby minimizing direct costs associated with cardiovascular disease management, with pitavastatin being of the newest generation of statins. This research work conducted a cost-utility analysis of pitavastatin to determine the economic benefit in Vietnam. Methods: A decision tree model was developed to compare the rate of LDL-C controlled patients over a lifetime horizon among patients treated with pitavastatin, atorvastatin, and rosuvastatin. The primary outcome was the incremental cost-effectiveness ratio (ICER), measured from the healthcare system perspective. Effectiveness was evaluated in terms of quality-adjusted life years (QALYs), using an annual discount rate of 3%. A one-way sensitivity analysis was performed to identify the key input parameters that most influenced the ICER outcomes. Results: Pitavastatin was cost-effective compared to atorvastatin but was dominated by rosuvastatin. Although pitavastatin gained fewer QALYs than atorvastatin, the ICER was 195,403,312 VND/QALY, well below Vietnam's 2024 willingness-to-pay. Drug cost had the most significant impact on ICERs. Conclusions: Pitavastatin represents an economical short-term alternative to atorvastatin, particularly in resource-constrained settings.