Exploring the Potential Health and Economic Benefits of Optimized Low-Density Lipoprotein Cholesterol Management in Malaysia’s Atherosclerotic Cardiovascular Disease Population: A Model-Based Analysis

This study quantified the health and economic benefits of improving low-density lipoprotein cholesterol (LDL-C) control in Malaysian patients with established atherosclerotic cardiovascular disease (ASCVD). It aimed to inform policy discussions and healthcare planning for effective ASCVD management. A deterministic, prevalence-based model was used to project the annual health burden and direct medical costs associated with recurrent ASCVD events over a 10-year horizon. The target population included adults (≥30 years) with established ASCVD and uncontrolled LDL-C levels (>1.8 mmol/L). The model comprised 3 modules: population size projection, recurrent ASCVD risk calculation (by means of the Secondary Manifestations of ARTerial disease [SMART] risk model), and direct medical and productivity cost estimation. The current status quo and a scenario with a 50% improvement in mean LDL-C were compared. We projected over 800 000 adults with established ASCVD in 2023, increasing to approximately 1.4 million by 2032. Under the status quo, about 55 000 recurrent ASCVD events were expected within 10 years, with significant direct medical costs and productivity losses. Improved LDL-C control could potentially reduce recurrent events by 7000 cases (13% reduction), prevent 2100 premature deaths, and save approximately 32 400 years of life. Economically, this could lead to a reduction of approximately 72 million MYR in direct medical costs and a gain of approximately 132.4 million MYR in productivity over a decade. Optimizing LDL-C control in high-risk patients with ASCVD presents a critical opportunity to reduce health and economic burdens in Malaysia. •Elevated low-density lipoprotein cholesterol (LDL-C) levels are a key risk factor for atherosclerotic cardiovascular disease, and their management is crucial for reducing cardiovascular events and mortality.•This article offers a comprehensive analysis of the projected health and economic benefits of improved LDL-C control in Malaysia, a context with specific healthcare challenges and demographics.•The findings highlight the potential for significant reductions in atherosclerotic cardiovascular disease events and healthcare costs with better LDL-C management, supporting evidence-based policy making and resource allocation in Malaysian healthcare.