Impact of Improved Low-Density Lipoprotein Cholesterol Control in Patients with Diabetes in Malaysia: A Model-Based Population Health and Economic Analysis

Objectives

Diabetes affects 537 million adults globally, significantly affecting non-high-income countries. Hyperlipidemia, a common comorbidity of diabetes, increases the risk of cardiovascular diseases, with low-density lipoprotein cholesterol (LDL-C) playing a crucial role. This study examines the population health outcomes and economic impact of improving LDL-C control among the population with diabetes in Malaysia.

Methods

Using a model-based approach, we projected the annual health burden of atherosclerotic cardiovascular disease (ASCVD) and the associated economic costs in Malaysia. The focus was on adults with diabetes and uncontrolled LDL-C. We used the UK Prospective Diabetes Study Outcome Model 2 for risk calculation, incorporating local demographic, clinical, and cost data to estimate the impact over a 10-year horizon.

Results

Our projections indicate a substantial burden from uncontrolled LDL-C in adults with diabetes, with over 1.24 (95% CI 1.15-1.34) million cumulative ASCVD cases and approximately 577 800 (95% CI 533 604-623 533) deaths over 10 years. Implementing effective LDL-C control measures could potentially prevent over 333 000 (95% CI 306 197-359 373) ASCVD events, 172 000 (95% CI 156 554-184 416) deaths, and more than 1.1 (95% CI 977 789-1 174 597) million years of life lost. Economically, it could reduce direct healthcare costs by RM 7.6 (95% CI 6.7-8.4) billion (∼30% reduction) and yield productivity gains of RM 7.5 (95% CI 5.8-8.7) billion over the decade.

Conclusions

This study underscores the values and urgency of incorporating LDL-C control into national health policies and clinical practices to address this pressing health issue effectively.