PHÂN TÍCH TÁC ĐỘNG NGÂN SÁCH CỦA PITAVASTATIN TRONG ĐIỀU TRỊ RỐI LOẠN LIPID MÁU THEO QUAN ĐIỂM CỦA CƠ QUAN CHI TRẢ BẢO HIỂM Y TẾ TẠI VIỆT NAM

Abstract

Background: Dyslipidemia stands as a significant risk factor for coronary artery disease and stroke. Pitavastatin, a novel synthetic 3-hydroxy-3-methylglutaryl reductase inhibitor, has been approved for the treatment of dyslipidemia. To evaluate the feasibility of incorporating pitavastatin into the Vietnamese health insurance drug list for the treatment of dyslipidemia, it is imperative to conduct a budget impact analysis of the drug on the health insurance fund. This analysis is essential to ensure the fiscal balance of reimbursement expenditures and the welfare of patients. Methods: We employed a Markov model with 6-step process to evaluate budget impact, data collected through a literature review, expert interview, and published data available Vietnam. Results: With a 100% health insurance coverage rate, treatment access rate ranging from 2.8% to 6.8%, the health insurance budget increased from 5.89 billion to 38.26 billion VND from 1st to 5th year. The health insurance budget in 5 yeas increased by 108.78 billion VND for the entire population and 178,994 VND per patient. Sensitivity analysis indicates that effectiveness of pitavastatin exert a more substantial budget impact than drug cost. Conclusions: The inclusion of pitavastatin in the Vietnamese health insurance drug list enhances patient access to treatment while simultaneously augmenting the health insurance payment budget. This forms the basis for the health insurance decision makers to deliberate on appropriate health insurance payment rates and conditions for pitavastatin in Vietnam.